Intracholedochal Knotting of a Guide-Wire

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Figure 1 A 56-year-old man was diagnosed with distal cholangiocellular carcinoma, and treatment with placement of a biliary stent by endoscopic retrograde cholangiopancreatography (ERCP) was planned. After the selective cannulization of the common bile duct, we tried to find a way through to the mass with a black guide-wire, but the tip of the guide-wire became knotted. The knot was recognised at fluoroscopy

Figure 2 The knotting was probably caused by reuse of a disposable guide-wire