Kawakatsu Yukino, Inoue Naonori, Okazaki Yuji, Hitomi Misuzu, Kawabata Hideaki, Miyata Masatoshi, Motoi Shigehiro
Department of Gastroenterology, Kyoto Okamoto Memorial Hospital.
Department of Health Care, Kyoto Okamoto Memorial Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2018;115(10):898-904. doi: 10.11405/nisshoshi.115.898.
A 58-year-old male receiving two types of antithrombotic medication developed acute obstructive suppressive cholangitis due to choledocholithiasis. During the first endoscopic retrograde cholangiopancreatography (ERCP) procedure, we performed biliary plastic stenting. Seven days after this procedure and with continued antithrombotic treatment, we performed ERCP with endoscopic sphincterotomy and stone extraction. Twelve hours after this procedure, the patient suffered transient unconsciousness and progression of anemia. Sixty hours after the procedure, he experienced right hypochondralgia and hiccups. Ultrasonography and computed tomography revealed a subcapsular hepatic hematoma. Bleeding was successfully arrested with selective arterial embolization. We suspected that the cause of these problems was vessel injury from the rigid portion of the guidewire during the ERCP procedure.
