ABSTRACT
Hemobilia is defined as a hemorrhage in the biliary tract and is most commonly associated with accidental or iatrogenic trauma. A case is herein reported of hemobilia developed in a hepatic artery aneurysm after biliary stenting was performed in patient with cholangiocarcinoma. A 63-year-old man was admitted with melena and had history of cholangiocarcinoma with an intraductal biliary stent. A hepatic artery angiography revealed two pseudoaneurysms at the common hepatic artery and right hepatic artery. Transarterial embolization with gelfoam was successfully received and hemobilia was not developed later.
Subject(s)
Humans , Middle Aged , Aneurysm , Aneurysm, False , Angiography , Biliary Tract , Cholangiocarcinoma , Gelatin Sponge, Absorbable , Hemobilia , Hemorrhage , Hepatic Artery , Melena , StentsABSTRACT
BACKGROUND/AIMS: Pancreas divisum is a congenital anomaly caused by failure of fusion of the ventral and dorsal pancreatic anlagen during the sixth and seventh week of gestation. With widespread use of endoscopic retrograde cholangiopancreatography(ERCP), pancreas divisum is being detected with increasing frequency. Pancreas divisum is the most common congenital pancreatic anatomic variant, occuring in approximately 4.7~14% of necropsy series and has been demonstrated 1.3~6.7% of patients undergoing ERCP, The condition is seen least frequently in Asian(1~2%). It has been postulated that this anomaly may be a cause of obstructive pancreatic pain and pancreatitis on the basis of impaired drainage through the minor papilla. But there is a controversy as to whether pancreas divisum is associated with an increased incidence of pancreatitis. This study is performed to evaluate the clinical presentation and significance of pancreas divisum. METHODS: 27 cases of pancreas divisum detected among 1,718 ERCP examinations performed from June, 1993 to December, 1996 at our institution were critically analyzed. RESULTS: Overall incidence of pancreas divisum was 1.6%. Among them, 13 cases(48.1%) were classified as complete type, 14 cases(51.9%) were classified as incomplete type. There was a significantly high incidence of pancreatitis, 22.2% in pancreas divisum compared with 5.6% in fused pancreas. Pancreas divisum was misdiagnosed as pancreatic head mass on radiological imaging study in 4 cases(25%). CONCLUSIONS: Pancreas divisum may be predispose to development of pancreatitis, and that its presence may lead to misinterpretation of ultrasonographic and CT scan findings.
Subject(s)
Humans , Pregnancy , Cholangiopancreatography, Endoscopic Retrograde , Drainage , Head , Incidence , Pancreas , Pancreatitis , Tomography, X-Ray ComputedABSTRACT
There are various reports referring to the clinical siignificances and removal of postgastrectomy bezoar. In this case, suture thread were thought to he the important factor of the bezoar formation, This bezoar was removed intaetly uaing fiber-optic endoscope in patinet who had postgastrectomy bezoar, by cutting the thread by biopsy forceps.