Portal vein cannulation: An uncommon complication of endoscopic retrograde cholangiopancreatography

Portal vein cannulation is a rare complication of endoscopic retrograde cholangiopancreatography (ERCP). It has been reported that it usually occurs after endoscopic sphincterotomy, whereas in cases without prior sphincterotomy, the presence of portobiliary fistulas has been shown. Here, we present a case in which cannulation of the portal vein occurred despite careful wire-guided cannulation and the absence of sphincterotomy. Although fatal cases of cerebral and pulmonary air and/or bile embolism have been reported in patients with combined portal and hepatic vein trauma after ERCP and sphincterotomy, isolated portal vein cannulation, as in the current case, does not usually result in mortality or serious morbidity. However, awareness of this rare complication is important so that no further intervention is performed.