Unexplained Urine Changes After EUS-HGS: A Rare Case Report

EUS-BD, including EUS-CDS and EUS-HGS, is an efficacious alternative to ERCP and its common complications are bile leak, infection, stent migration and bleeding. Here, we report an atypical case of a patient who developed dark green urine after receiving EUS-HGS, which we suspected to be caused by an abnormal biliary-vascular fistula. A 76-year-old woman diagnosed with pancreatic adenocarcinoma received EUS-HGS for relieving jaundice. The patient reported abdominal pain and chest tightness after the operation, with difficulty in urinating. X-ray suggested right-sided pleural effusion and dark green pleural effusion was drained out. However, the patient also developed dark green urine, which appeared everyday afternoon and disappeared automatically after intravenous treatment. The phenomenon was rare and interesting ,and also called for more alert on post-operative complication detection after EUS-BD operation.