Intracholedochal varices in portal hypertensive biliopathy

Portal hypertensive biliopathy (PHB) is associated with CBD stones in some cases. Removal of stone can cause bleeding. The exact cause of bleeding has been assumed to be from two groups of Epicholedochal (ECD) venous plexus and para-choledochal (PCD) venous plexus. The presence of these two plexuses does not explain the cause of bleeding during therapeutic ERCP. This case shows the presence of intracholedochal collaterals by Color Doppler Ultrasound (CDUS) and Endoscopic Ultrasound (EUS) which can be the cause of bleeding during ERCP.