There have been rare reports of damage to the blood vessels surrounding the bile duct during the gallstone removal process, causing hemobilia. In cases of severe hemobilia with unstable vital signs, insertion of a fully covered self-expanding metallic stent (SEMS) may be considered as salvage therapy. This case reports a patient with common bile duct stones and acute cholangitis who developed massive hemobilia during attempts to resolve basket device incarceration by performing mechanical lithotripsy. Endoscopic hemostasis was successfully achieved by insertion of a SEMS. However, during follow-up, the stent distally dislocated, resulting in rebleeding with a pseudoaneurysm in the surrounding blood vessels. Ultimately, hemostasis failed despite vascular intervention and additional hemostatic procedures, leading to death. Even if a stent is inserted in an appropriate location, hemostasis may not be achieved well, and if the stent migrates, hemobilia may worsen, so close monitoring is required to determine whether bleeding occurs again.

There have been rare reports of damage to the blood vessels surrounding the bile duct during the gallstone removal process, causing hemobilia. In cases of severe hemobilia with unstable vital signs, insertion of a fully covered self-expanding metallic stent (SEMS) may be considered as salvage therapy. This case reports a patient with common bile duct stones and acute cholangitis who developed massive hemobilia during attempts to resolve basket device incarceration by performing mechanical lithotripsy. Endoscopic hemostasis was successfully achieved by insertion of a SEMS. However, during follow-up, the stent distally dislocated, resulting in rebleeding with a pseudoaneurysm in the surrounding blood vessels. Ultimately, hemostasis failed despite vascular intervention and additional hemostatic procedures, leading to death. Even if a stent is inserted in an appropriate location, hemostasis may not be achieved well, and if the stent migrates, hemobilia may worsen, so close monitoring is required to determine whether bleeding occurs again.

There have been rare reports of damage to the blood vessels surrounding the bile duct during the gallstone removal process, causing hemobilia. In cases of severe hemobilia with unstable vital signs, insertion of a fully covered self-expanding metallic stent (SEMS) may be considered as salvage therapy. This case reports a patient with common bile duct stones and acute cholangitis who developed massive hemobilia during attempts to resolve basket device incarceration by performing mechanical lithotripsy. Endoscopic hemostasis was successfully achieved by insertion of a SEMS. However, during follow-up, the stent distally dislocated, resulting in rebleeding with a pseudoaneurysm in the surrounding blood vessels. Ultimately, hemostasis failed despite vascular intervention and additional hemostatic procedures, leading to death. Even if a stent is inserted in an appropriate location, hemostasis may not be achieved well, and if the stent migrates, hemobilia may worsen, so close monitoring is required to determine whether bleeding occurs again.

There have been rare reports of damage to the blood vessels surrounding the bile duct during the gallstone removal process, causing hemobilia. In cases of severe hemobilia with unstable vital signs, insertion of a fully covered self-expanding metallic stent (SEMS) may be considered as salvage therapy. This case reports a patient with common bile duct stones and acute cholangitis who developed massive hemobilia during attempts to resolve basket device incarceration by performing mechanical lithotripsy. Endoscopic hemostasis was successfully achieved by insertion of a SEMS. However, during follow-up, the stent distally dislocated, resulting in rebleeding with a pseudoaneurysm in the surrounding blood vessels. Ultimately, hemostasis failed despite vascular intervention and additional hemostatic procedures, leading to death. Even if a stent is inserted in an appropriate location, hemostasis may not be achieved well, and if the stent migrates, hemobilia may worsen, so close monitoring is required to determine whether bleeding occurs again.

There have been rare reports of damage to the blood vessels surrounding the bile duct during the gallstone removal process, causing hemobilia. In cases of severe hemobilia with unstable vital signs, insertion of a fully covered self-expanding metallic stent (SEMS) may be considered as salvage therapy. This case reports a patient with common bile duct stones and acute cholangitis who developed massive hemobilia during attempts to resolve basket device incarceration by performing mechanical lithotripsy. Endoscopic hemostasis was successfully achieved by insertion of a SEMS. However, during follow-up, the stent distally dislocated, resulting in rebleeding with a pseudoaneurysm in the surrounding blood vessels. Ultimately, hemostasis failed despite vascular intervention and additional hemostatic procedures, leading to death. Even if a stent is inserted in an appropriate location, hemostasis may not be achieved well, and if the stent migrates, hemobilia may worsen, so close monitoring is required to determine whether bleeding occurs again.

In neurosurgical cases, problems related to wound healing can vary from simple wound dehiscence to multilayer defects. This study demonstrates an effective method to prevent persistent cerebrospinal fluid (CSF) leakage using reinforcing acellular dermal matrix in neurosurgical patients with wound dehiscence. A 52-year-old woman was admitted for management of recurrent glioblastoma. After tumor removal surgery, the patient experienced sustained CSF leakage from the wound despite reparative attempts. The plastic surgery team performed wound repair procedure after remnant tumor removal by the neurosurgery team. Acellular dermal matrix was applied over the mesh plate to prevent CSF leakage and the postoperative status of the patient was evaluated. No sign of CSF leakage was found in the immediate postoperative period. After 3 years, there were no complications including CSF leakage, wound dehiscence, and infection. We hereby propose this method as a feasible therapeutic alternative for preventing CSF leakage in patients experiencing wound problem after neurosurgical procedures.

Reduction mandibuloplasty is one of the most frequently performed aesthetic surgical procedures in Korea. Cases of facial nerve injury after mandibuloplasty have been reported, but most of those cases have not been clearly presented in detail. This report describes the case of a 38-year-old patient who underwent reduction mandibuloplasty at a local plastic surgery clinic. A massive bleeding event occurred during surgery, and hemostasis was performed by a surgeon at the local clinic. During an exploratory procedure, we found that the facial nerve trunk was clipped with a metallic hemoclip. We then straightened the pressed epineurium to its original shape under surgical microscopy. Oral prednisolone administration began on the first day after the procedure and was gradually tapered off. The patient showed some improvement after 7 weeks and showed 80% to 90% improvement after 5 months.