title: Portal Biliopathy Causing Recurrent Biliary Obstruction and Hemobilia.
abstract: A 63-year-old man with extrahepatic portal vein thrombosis presented with biliary obstruction and hemobilia after a liver biopsy. Balloon sweep of the common bile duct removed clotted blood, and cholangiogram showed a common bile duct narrowing, treated with biliary stenting. A percutaneous biliary catheter was later required for recurrent biliary obstruction and hemobilia, and repeat cholangiogram confirmed portal biliopathy-a large peri-biliary varix was compressing the common bile duct, causing biliary obstruction and intermittent portal hypertensive hemobilia. A transjugular intrahepatic portosystemic shunt was inserted, followed by embolization of the peri-biliary varix. Delayed diagnosis of portal biliopathy may lead to significant patient morbidity.
authors.affiliation: Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, OR.
authors.forename: Barry
authors.initials: B
authors.lastname: Schlansky
authors.affiliation: Dotter Interventional Institute, Oregon Health and Science University, Portland, OR.
authors.forename: John A
authors.initials: JA
authors.lastname: Kaufman
authors.affiliation: Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, OR.
authors.forename: Gene
authors.initials: G
authors.lastname: Bakis
authors.affiliation: Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, OR.
authors.forename: Willscott E
authors.initials: WE
authors.lastname: Naugler