Vascular anomaly as a cause of late bleeding after endoscopic retrograde cholangiopancreatography: A case report.

Abstract

Background: Post-endoscopic retrograde cholangiopancreatography (ERCP) bleeding is a serious complication, and related case reports have described various bleeding events following ERCP, including injury to the right gastroepiploic artery, bleeding from biliary varices, retroperitoneal hematoma in liver transplant recipients and subcapsular liver hematoma after ERCP.

Case summary: We present a case of a 55-year-old male patient who developed post-ERCP hemorrhage one month after undergoing ERCP, endoscopic sphincterotomy, and bile duct stone removal for acute biliary pancreatitis. The patient presented with upper abdominal pain and melena, and imaging studies revealed high-density shadows in the intrahepatic bile duct, gallbladder, and lower segment of the common bile duct, suggestive of bleeding. Emergency interventional embolization was performed, and subsequent endoscopic and interventional therapies were implemented to control the bleeding. The patient's hemoglobin levels gradually improved, and biliary indicators normalized.

Conclusion: Post-ERCP bleeding can result from various etiologies, and the rupture of variant vessels is a noteworthy topic warranting further exploration.