Bile duct injury and severe bleeding after endoscopic papillary large balloon dilation without sphincterotomy: a case report.

We report the case of an 80-year-old woman with multiple choledocholithiasis who suffered severe bleeding after endoscopic papillary large balloon dilation (EPLBD). Astriction by balloon tamponade and a covered, self-expandable, metallic stent failed. However, embolization using a transcatheter arterial coil stopped the bleeding. After hemostasis was achieved, a bile duct injury was observed. We presume that a bile duct stone, which had remained in the lower common bile duct, entered the balloon and the bile duct and caused the bile duct injury. This case emphasizes the need for careful attention during EPLBD.