This was a 24 year old gentleman who had undergone a live related liver transplant for Hepatitis B related liver cirrhosis in June 2013. His last ERCP was in December 2013 when 2 biliary plastic stents, both of 10 French diameter, one 10 and the other 12 cm long were placed after balloon stricturoplasty http://ercp365.blogspot.com/2013/12/follow-up-case-of-post-liver-transplant.html. He had now been developing episodes of fever and hypochondrial pain. An ERCP was scheduled and the said stents were seen to be blocked (A1) and removed with a snare (A2). Contrast injection showed the narrowing in the strictured area (B: white arrow). A guidewire (C: red arrow) and 10mm diameter TTS balloon assembly (C: white arrow) were passed across the strictured segment. The balloon was inflated with complete obliteration of waist (D & E: white arrows). Repeat contrast injection showed significant improvement in the anastomotic stricture site (F: white arrows). This time we decided not to pass any stents. The case will be followed up serial LFTs and ultrasound.
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