Delayed bleeding after precut sphincterotomy successfully treated with a novel self-assembling peptide gel

Abstract

An 84-year-old woman was referred to our hospital because of obstructive jaundice associated with common bile duct stones. She had a history of cardioembolic stroke and was taking the direct oral anticoagulant (DOAC) edoxaban. ERCP was performed by use of the precut sphincterotomy technique, and a biliary stent was inserted. After the onset of hematemesis 2 days later, she was mildly anemic (hemoglobin 10.4 g/dL). Emergency ERCP revealed a coagulum and oozing bleeding between the papilla and the stent (A).