Radiation-Induced Stricture Of The Papilla And The Common Bile Duct. Successful Treatment With Balloon Dilation

Radiation-induced lesions of the bile ducts rarely occur and may be difficult to manage. We report the case of a 59-year old woman who developed radiation-induced stenosis of the papilla and the common bile duct 25 years after abdominal radiation therapy for abdominal non-Hodgkin's lymphoma. She presented with recurrent cholangitis and chronic cholestasis. Endoscopic results showed dilation of the intrahepatic bile ducts, radiation-induced inflammation and narrowing of the antrum and the duodenum, and stricture of the papilla and the lost few millimeters of the common bile duct. The patient was treated with endoscopic balloon dilation. Forty-two months after endoscopic dilation, the patient remained asymptomatic with normal liver tests and no biliary dilation at ultrasound.