Document Detail

Vascular biliopathy as a cause of common bile duct obstruction successfully treated by mesocaval shunt and endoscopic retrograde cholangiopancreatography biliary stent placement.
MedLine Citation:
PMID:  19344595     Owner:  NLM     Status:  MEDLINE    
Common bile duct stenosis owing to extrahepatic portal varices is termed "portal hypertensive biliopathy" (PHB) and is a rare occurrence. We report a case of PHB owing to portal vein thrombosis with cavernous transformation successfully managed by mesocaval shunt and endoscopic retrograde cholangiopancreatography (ERCP) biliary stent placement. A 44-year-old male, who presented with hematemesis, melena, jaundice, and abdominal pain, underwent gastroscopy, which revealed bleeding gastric varices. Computed tomography with arterial and venous imaging demonstrated portal vein thrombosis with cavernous transformation and extensive extrahepatic varices within the porta hepatis causing common bile duct obstruction from extrinsic compression. Biliary decompression was achieved with ERCP, and a small common bile duct stone was retrieved. A mesocaval shunt with a 16 mm Dacron graft successfully treated the portal hypertension. PHB is rare. We report a case successfully treated by mesocaval shunt and ERCP.
Martin D Rosenthal; Geoffrey H White; Michael S Stephen; James J Gallagher; Charbel Sandroussi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Vascular     Volume:  16     ISSN:  1708-5381     ISO Abbreviation:  Vascular     Publication Date:    2008 Nov-Dec
Date Detail:
Created Date:  2009-04-06     Completed Date:  2009-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101196722     Medline TA:  Vascular     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  356-8     Citation Subset:  IM    
Mercer University School of Medicine, Macon, GA 30312, USA.
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MeSH Terms
Blood Vessel Prosthesis Implantation
Cholangiopancreatography, Endoscopic Retrograde
Cholestasis, Extrahepatic / etiology*,  radiography,  surgery
Common Bile Duct / radiography,  surgery
Hypertension, Portal / complications*,  radiography,  surgery
Portal Vein* / radiography
Tomography, X-Ray Computed
Varicose Veins / complications*,  radiography,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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