Atlas of Gastroenterological Endoscopy
| Home |
next |
previous |
glossary |
E-Mail |
Hemorrhage after papillotomy
Late hemorrhage after EPT Hemobilia
A colic attack 24 h after sphincterotomy and stone extraction prompts a second ERC. An oozing hemorrhage from the papillary roof is seen.
The x- ray shows filling defects up to the hepatic fork. A massive intraductal clot is diagnosed as cause of the colic attack.
Move the mouse arrow over the x-ray to highlight the coagulum.
Hemobilia, coagulum 1 day after treatment After treatment
Lavage of the biliary duct prooves the suspected hemobilia. Massive clots can be removed from the duct. After fibrin application to the site of hemorrhage, the bleeding stops. One day after the hemorrhage the papilla is still covered by fibrin, no active hemorrhage is visible. To secure biliary flow a stent is deployed. Elective stent removal is performed after 2 weeks.