Distinguishing Etiology of Biliary Stricture Using the SpyGlass™ DS System by Ajay Jain, M.D.

An 82-year-old female with a history of chronic atrial fibrillation on coumadin was directly admitted with a supratherapeutic INR >13. She was found to have increased LFTs and RUQ US findings of biliary ductal dilation with gallbladder sludge. A CT scan of the abdomen revealed biliary dilation and findings suggestive of chronic pancreatitis. In an effort to determine the nature of the biliary obstruction, the patient was set up for an ERCP with cholangioscopy.