Fig. 3. Active bleeding after endoscopic ultrasound (EUS)-guided, biliary drainage for ampulla of the Vater cancer patient. (A) Endoscopic image shows a hepaticogastrostomy stent which was inserted under the EUS in the stomach. (B) Non-enhanced abdominal computed tomography scan shows a hepaticogastrostomy stent with a hematoma within the stent and common hepatic duct (arrows). There was no active contrast extravasation. Endoscopy was not possible due to the large amount of gastric contents. (C) Left hepatic arteriogram shows a large pseudoaneurysm (arrow) around the hepaticogastrostomy stent insertion site. (D) Embolization using a coil and N-butyl cyanoacrylate was performed (not shown). The post-embolization celiac angiogram shows no more active bleeding.

Int J Gastrointest Interv 2019;8:134~139 https://doi.org/10.18528/ijgii190009

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