Occluded biliary stent

Case contributed by Muhammad Shoyab

Presentation

Obstructive jaundice due to gall bladder carcinoma with invasion of common bile duct and hepatic metastasis. ERCP and stenting done 2 days ago. Persistent jaundice with high bilirubin and alkaline phosphatase.

Patient Data

Age: 40 years
Gender: Male

X-Ray Abdomen

x_ray

Stent along course of common bile duct. No air within biliary tree.
No free gas under either dome of diaphragm.
Distended bowel loops in lower abdomen, but no air-fluid levels.

Case Discussion

Presence of pneumobilia is a reliable assurance of the patency of a biliary stent.

Conversely, absence, reduction or resolution of pneumobilia is also a very reliable indicator of stent occlusion.

The distended bowel loops in lower abdomen likely represent normal post-procedure change.

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