Fig. 12.

( a and b ) In a patient with primary biliary cirrhosis and a TIPS for recurrent GI bleeding that developed recurrent E. coli bacteremia for last 8 months. CT scan shows area of focal biliary dilatation (arrow) and segmental atrophy posterior to the TIPS stent. ERCP was unable to visualize intrahepatic area. ( c ) Percutaneous biliary cholangiogram shows focal dilation of segmental branches in segment 6 (arrows) produced by external compression by the stent. ( d ) An internal/external biliary drain was placed with later placement of a plastic stent with resolution of the bacteremia.