title: Late-onset severe biliary bleeding after endoscopic pigtail plastic stent insertion.
abstract: Here, we report our experience with a case of severe biliary bleeding due to a hepatic arterial pseudoaneurysm that had developed 1 year after endoscopic biliary plastic stent insertion. The patient, a 78-year-old woman, presented with hematemesis and obstructive jaundice. Ruptured hepatic arterial pseudoaneurysm was diagnosed, which was suspected to have been caused by long-term placement of an endoscopic retrograde biliary drainage (ERBD) stent. This episode of biliary bleeding was successfully treated by transarterial embolization (TAE). Pseudoaneurysm leading to hemobilia is a rare but potentially fatal complication in patients with long-term placement of ERBD. TAE is a minimally invasive procedure that offers effective treatment for biliary bleeding.
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Muneji
authors.initials: M
authors.lastname: Yasuda
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Sato
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Koyama
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Sakakida
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Kawakami
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishimura
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Nakatsugawa
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Tomatsuri
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okuyama
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kimura
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ito
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Morishita
authors.affiliation: Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.
authors.forename: Norimasa
authors.initials: N
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D017541:Aneurysm, False; D001659:Biliary Tract / Q000473:pathology*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D000072226:Computed Tomography Angiography; D004322:Drainage / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006396:Hematemesis; D006431:Hemobilia / Q000209:etiology; D006470:Hemorrhage; D006499:Hepatic Artery / Q000473:pathology*; D006801:Humans; D015994:Incidence; D041781:Jaundice, Obstructive / Q000175:diagnosis; D010969:Plastics / Q000009:adverse effects*; D019919:Prosthesis Implantation / Q000009:adverse effects; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010969:Plastics
keywords: Biliary bleeding; Biliary stent; Pigtail stent; Plastic stent; Pseudoaneurysm