# A Case of Spurting Bleeding After Endoscopic Papillary Balloon Dilation

## TL;DR

A 58-year-old man with a bleeding risk had a medical procedure to remove a bile duct stone, but experienced heavy bleeding afterward.

## Contribution

Highlights a rare but severe bleeding complication after endoscopic papillary balloon dilation in a high-risk patient.

## Key findings

- The patient developed spurting bleeding after the procedure despite a history of successful EPBD.
- Endoscopic hemostasis was required to manage the bleeding.
- The patient recovered with conservative management despite mild pancreatitis.

## Abstract

A 58-year-old male with acute cholangitis due to a common bile duct stone underwent endoscopic retrograde cholangiopancreatography for stone removal with endoscopic papillary balloon dilation (EPBD) due to his high bleeding risk owing to maintenance dialysis and antiplatelet and anticoagulant medications. He had a history of stone removal using an EPBD. The stone was removed; however, the patient subsequently developed spurting bleeding and underwent endoscopic hemostasis. Despite the subsequent mild pancreatitis, he recovered with conservative management. While EPBD is considered a low-risk procedure for bleeding, caution should still be exercised due to the possibility of massive postprocedural bleeding.