Occluded biliary stent

Case contributed by Muhammad Shoyab
Diagnosis almost certain

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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