{"id":5874,"date":"2024-11-05T09:56:33","date_gmt":"2024-11-05T12:56:33","guid":{"rendered":"https:\/\/revistaabcd.org.br\/?p=5874"},"modified":"2024-12-05T11:15:45","modified_gmt":"2024-12-05T14:15:45","slug":"portal-vein-thrombosis-after-iatrogenic-endoscopic-biliary-prosthesis-placement","status":"publish","type":"post","link":"https:\/\/revistaabcd.org.br\/pt-br\/portal-vein-thrombosis-after-iatrogenic-endoscopic-biliary-prosthesis-placement\/","title":{"rendered":"PORTAL VEIN THROMBOSIS AFTER IATROGENIC ENDOSCOPIC BILIARY PROSTHESIS PLACEMENT"},"content":{"rendered":"<h2 class=\"articleSectionTitle\">INTRODUCTION<\/h2>\n<p>Endoscopic stent placement has become a well-established treatment in the management of biliary tract obstruction<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/zM7VtH6xHBYWRGnxVdjLBqj\/?lang=en#B8_ref\" data-ref=\"8\u00a0 8 Ricci E, Mortilla MG, Conigliaro R, Bertoni G, Bedogni G, Chilovi F. Portal vein filling: a rare complication associated with ERCP for endoscopic biliary stent placement. Gastrointest Endosc. 1992;38(4):524-5. https:\/\/doi.org\/10.1016\/s0016-5107(92)70503-3 \" rel=\"nofollow noopener\" target=\"_blank\">8<\/a><\/sup><\/span>. Complications such as pancreatitis, hemorrhage, duodenal perforation, or cholangitis can occur in up to 10% of insertions<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/zM7VtH6xHBYWRGnxVdjLBqj\/?lang=en#B4_ref\" data-ref=\"4\u00a0 4 Huibregtse K, Gish R, Tytgat GN. A frightening event during endoscopic papillotomy. Gastrointest Endosc. 1988;34(1):67-8. https:\/\/doi.org\/10.1016\/s0016-5107(88)71239-0 \" rel=\"nofollow noopener\" target=\"_blank\">4<\/a><\/sup><\/span>,<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/zM7VtH6xHBYWRGnxVdjLBqj\/?lang=en#B6_ref\" data-ref=\"6\u00a0 6 Kang J, Park YT, Kim HJ, Kim JS. Delayed hemobilia caused by penetration of biliary plastic stent into portal vein. Korean Journal of Pancreas and Biliary Tract. 2022;27(3):135-9. https:\/\/doi.org\/10.15279\/kpba.2022.27.3.135 \" rel=\"nofollow noopener\" target=\"_blank\">6<\/a><\/sup><\/span>,<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/zM7VtH6xHBYWRGnxVdjLBqj\/?lang=en#B8_ref\" data-ref=\"8\u00a0 8 Ricci E, Mortilla MG, Conigliaro R, Bertoni G, Bedogni G, Chilovi F. Portal vein filling: a rare complication associated with ERCP for endoscopic biliary stent placement. Gastrointest Endosc. 1992;38(4):524-5. https:\/\/doi.org\/10.1016\/s0016-5107(92)70503-3 \" rel=\"nofollow noopener\" target=\"_blank\">8<\/a><\/sup><\/span>. Iatrogenic perforation of the portal vein during the procedure or stent migration to the portal system are unusual complications, and due to scarce reports in the literature, there is no consensus on how to manage it<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/zM7VtH6xHBYWRGnxVdjLBqj\/?lang=en#B1_ref\" data-ref=\"1\u00a0 1 Chaitowitz IM, Heng R, Bell KW. Management of iatrogenic porto-biliary fistula following biliary stent. Australas Radiol. 2007;51 Suppl:B316-8. https:\/\/doi.org\/10.1111\/j.1440-1673.2007.01767.x \" rel=\"nofollow noopener\" target=\"_blank\">1<\/a><\/sup><\/span>,<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/zM7VtH6xHBYWRGnxVdjLBqj\/?lang=en#B2_ref\" data-ref=\"2\u00a0 2 Dawwas MF, Huang JY, Rowe A, Yim DB, Samarasena JB, Chang KJ, et al. EUS diagnosis and endoscopic management of iatrogenic biliary stent placement into the portal vein. Gastrointest Endosc. 2014;80(2):338. https:\/\/doi.org;10.1016\/j.gie.2014.04.033 \" rel=\"nofollow noopener\" target=\"_blank\">2<\/a><\/sup><\/span>,<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/zM7VtH6xHBYWRGnxVdjLBqj\/?lang=en#B11_ref\" data-ref=\"11\u00a0 11 Walton H, Yu D, Imber C, Webster G. Portal vein pseudoaneurysm secondary to pancreatic lymphoma and biliary stent insertion: a rare cause of haemobilia. CVIR Endovasc. 2018;1(1):5. https:\/\/doi.org\/10.1186\/s42155-018-0011-7 \" rel=\"nofollow noopener\" target=\"_blank\">11<\/a><\/sup><\/span>.<\/p>\n<p>Here, we present a case of portal thrombosis secondary to an accidental portal insertion of a biliary stent. The study was approved by the Ethics Committee of the Institution (number 76693423.1.0000.0068).<\/p>\n<h2 class=\"articleSectionTitle\">CASE REPORT<\/h2>\n<p>A 44-year-old female presented in another medical institution with acute upper abdominal pain, jaundice, and vomiting, and was diagnosed with mild acute biliary pancreatitis. Magnetic resonance imaging (MRI) showed choledocholithiasis. As the jaundice persisted, she underwent endoscopic retrograde cholangiopancreatography (ERCP). After undergoing papillotomy and plastic stent placement, the clinical jaundice subsided. The clinical report did not mention technical difficulties.<\/p>\n<p>After 4 months, the patient was referred to our outpatient facility due to upper abdominal pain and generalized pruritus. Blood tests showed: total bilirubin, 2.06 mg\/dL (reference range, 0.2-1.2 mg\/dL); direct bilirubin, 1.0 mg\/dL (up to 0.5 mg\/dL); indirect bilirubin, 1.1 mg\/dL (0.2-0.7 mg\/dL); alkaline phosphatase, 270 U\/L (40-150 U\/L), and gamma-glutamyl transferase, 431 U\/L (12-64U\/L).<\/p>","protected":false},"excerpt":{"rendered":"<p>INTRODUCTION Endoscopic stent placement has become a well-established treatment in the management of biliary tract obstruction8. Complications such as pancreatitis, hemorrhage, duodenal perforation, or cholangitis can occur in up to 10% of insertions4,6,8. Iatrogenic perforation of the portal vein during the procedure or stent migration to the portal system are unusual complications, and due to [&hellip;]<\/p>","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"categories":[10],"tags":[],"class_list":["post-5874","post","type-post","status-publish","format-standard","hentry","category-letter-to-the-editor"],"acf":[],"modified_by":"Giovani","_links":{"self":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts\/5874","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/comments?post=5874"}],"version-history":[{"count":2,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts\/5874\/revisions"}],"predecessor-version":[{"id":5877,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts\/5874\/revisions\/5877"}],"wp:attachment":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/media?parent=5874"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/categories?post=5874"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/tags?post=5874"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}