title: Vascular Injury Following Pyloric Dilation: Unusual Cause of Ischemic Colitis.
abstract: A 57-year-old female with intrahepatic cholangiocarcinoma underwent hepatic trisegmentectomy and chemoradiation. Her course was complicated by recurrent episodes of radiation-induced gastric outlet obstruction requiring balloon dilations. She presented with right lower quadrant pain after routine upper endoscopy with pyloric dilation. A computed tomography (CT) showed isolated right-sided ischemic colitis with vascular contrast in the mesentery. Repeat CT after conservative management revealed near resolution of the ischemic changes. Perforation at the level of the pylorus is a complication of endoscopic pyloric dilation but vascular injury has never been described.
authors.affiliation: Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Riff
authors.affiliation: Department of Surgery, University of Pennsylvania, Philadelphia, PA.
authors.forename: Cary B
authors.initials: CB
authors.lastname: Aarons
authors.affiliation: Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA.
authors.forename: David C
authors.initials: DC
authors.lastname: Metz