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Case Reports
. 2025 Aug 4;12(8):e01793.
doi: 10.14309/crj.0000000000001793. eCollection 2025 Aug.

Resistant Hilar Stricture Following Transarterial Bleomycin-Lipiodol Embolization for a Large Hepatic Hemangioma

Man Ting Kristina Yau  1 , Cynthuja Thilakanathan  1 , Hyun Jae Kim  1 , Stephen G F Ho  2 , Roberto P Trasolini  1 , S Ian Gan  1 , Maja Segedi  3
Affiliations
Case Reports

Resistant Hilar Stricture Following Transarterial Bleomycin-Lipiodol Embolization for a Large Hepatic Hemangioma

Man Ting Kristina Yau et al. ACG Case Rep J. .

Abstract

Symptomatic hepatic hemangiomas are commonly treated by transcatheter arterial embolization as an alternative to surgical resection. Bile duct complications are rare. An 80-year-old woman had a progressive refractory stricture postbleomycin transcatheter arterial chemoembolization. Magnetic resonance cholangiopancreatography showed that the hemangioma reduced in size, but there was a new 2 cm hilar stricture on cholangiopancreatography. Digital cholangioscopy and biopsy showed benign changes. Despite repeat dilations and stent treatments, she had persistent stricture and recurrent cholangitis. The stricture was not operable. The stricture was likely from angiosclerotic effects of bleomycin. The bile duct is prone to ischemic injury as it lacks dual blood supply.

Keywords: biliary strictures; hemangioma; transcatheter arterial chemoembolization.

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Figures

Figure 1.
Figure 1.
Segment VI 8.1 cm hepatic hemangioma.
Figure 2.
Figure 2.
Bleomycin-lipiodol transarterial chemoembolization of the right hepatic artery (black arrow).
Figure 3.
Figure 3.
Reduction in size of the hepatic hemangioma postbleomycin transarterial chemoembolization on computed tomography.
Figure 4.
Figure 4.
Two centimeters hilar stricture extending into the common hepatic duct on magnetic resonance cholangiopancreatography (white arrow).
Figure 5.
Figure 5.
Benign stricture with frond-like mucosa, reduced vascular pattern, and fibrotic base on digital cholangioscopy.
See this image and copyright information in PMC

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