Chronic pancreatitis post abdominal trauma leading to pancreatic duct strictures

This patient was a 20 year old gentleman who had suffered blunt abdominal trauma during motorcycle accident. He developed a pancreatic abscess which was managed conservatively. Over the past one year he had repeated episodes of pancreatitis. His MRCP showed two pancreatic duct strictures at the junction of head and body and in the body (A: White arrows). The same were seen during contrast injection during ERCP (B: Black arrows). We did a pancreatic papillotomy (C: Black arrow), following which the pancreatic duct was dilated along its length using an 8mm x 30 mm biliary stricture dilatation balloon (D1 -D3: Black arrows). A stent assembly was then placed into the pancreatic duct (E: Black arrows). A 7 French plastic stent of 10 cm length was then placed (F: Black arrows).

Second ERCP for post liver transplant anastomotic biliary structure (Case G)

This 65 year old gentleman last underwent ERCP for his biliary stricture three months earlier http://ercp365.blogspot.co.uk/2015/04/post-liver-transplant-anastomotic_76.html. We had placed a 10 French plastic stent of 12 cm length at that time. He now presented with pruritis, mildly raised bilirubin and markedly raised ALP levels. An ultrasound showed no pneumobilia and prominence of intrahepatic biliary channels. We pulled the old stent (A: White arrow & B) with a snare (A: Black arrow). Contrast injection outlined the stricture site (C: Black arrow). We dilated the track with a graduated dilatation catheter, size 7.5F  to 10 French (D: Black arrow shows the dilation catheter crossing the stricture site) and placed a 12 cm long stent of 10 French size (E:Black arrows), same as last time .