Extrinsic biliary compression in a patient with Familial Adenomatous Polyposis

This 35 year old gentleman was a diagnosed case of Familial Adenomatous Polyposis who had developed obstructive jaundice secondary to extrinsic biliary compression. This was evident on MRCP (A: red arrow). This was most likely a lymph node exerting pressure on the bile duct. Contrast injection on ERCP confirmed the MRCP findings (B: red arrow). We dilated the stricture tract with a 10 French dilator (C: black arrows). Further advancement of the dilator revealed a sharp bend (D: white arrow marks the bend. Black arrows delineate the stent). A 12cm long plastic stents of 10 French diameter was placed (E: white arrow shows the "kink" in the stent at the aforementioned bend. Black arrows outline the stent). A snare was used to pull the stent back to straighten it out (F: red arrow shows the snare around the stent. G: black arrows mark the non kinked stent, properly deployed).