Hemobilia

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Endoscopic retrograde cholangiopancreaticography ERCP is considered to be an excellent diagnostic and treatment modality. Thirty-seven cases of hemobilia with different underlying pathologies were analyzed to illustrate clinical features and to evaluate the role of endoscopic management. Methods A total of 37 patients 26 men and 11 women; mean age, Patients with iatrogenic causes of hemobilia were excluded in this study. Results The causes of hemobilia were hepatocellular carcinoma in 14, bile duct and gallbladder malignancies in 12, common bile duct stones with cholangitis in 4, acute cholecystitis in 4, and pancreatic cancer in 2 patients. The clinical features of hemobilia were jaundice The cholangiographic findings of hemobilia were amorphous filling defects in 15, tubular filling defects in 6, and cast-like filling defects in 6 patients.

Hemobilia

Hemobilia is an uncommon source of significant gastrointestinal bleeding resulting from a communication between the vascular and biliary systems. Iatrogenic injury to the liver and the biliary system from percutaneous transhepatic techniques is currently the leading cause of hemobilia. Trauma, operative injury, malignancy, and inflammatory diseases of the hepatobiliary system are other rare, but important, etiologies for clinically significant hemobilia. While diagnostic CT angiography can be used in clinically stable patients, interventional angiography and transcatheter percutaneous endovascular techniques are the standard for diagnosis and treatment of hemobilia. Operative intervention is not required for management in the vast majority of the patients. Appropriate biliary drainage must be ensured after bleeding is addressed. Elizabeth V. Hemobilia is an uncommon source of bleeding resulting from a communication between the vascular and biliary systems. Historically, hemobilia has been associated with the triad of symptoms described by Heinrich Quincke in including pain, gastrointestinal bleeding, and jaundice. We aim to provide a current update, focusing on common patient presentations and modern management strategies. The predominant etiology for hemobilia has changed over time. Historically, hemobilia was associated most commonly with external trauma, both penetrating and blunt.

Although minor hemobilia can be managed conservatively with correction of hemobilia and fluid hydration, hemobilia usually requires endoscopic therapy, hemobilia, radiologic intervention, or surgery. Hemobilia: a rare complication of cholecystitis and cholecystolithiasis. Quincke H.

Federal government websites often end in. The site is secure. JB Hemobilia is bleeding from the biliary tree. It is a rare cause of upper gastrointestinal bleeding. If the diagnosis of hemobilia is not considered, it may be missed. However, the clue to diagnosing this condition is that it often follows medical procedures. JB Approximately two thirds of hemobilia cases result from medical interventions ie, the cases are iatrogenic.

Federal government websites often end in. The site is secure. Reports of hemobilia date back to the s, but due to its relative rarity and challenges in diagnosis, only in recent decades has hemobilia been more critically studied. A classic triad of right upper quadrant pain, jaundice, and overt upper gastrointestinal bleeding has been described i. The treatment of hemobilia depends on its severity and suspected source and ranges from supportive care to advanced endoscopic, interventional radiologic, or surgical intervention.

Hemobilia

Goal and background: A literature review to improve practitioners' knowledge and performance concerning the epidemiology, diagnosis, and management of hemobilia. Study: A search of Pubmed, Google Scholar, and Medline was conducted using the keyword hemobilia and relevant articles were reviewed and analyzed. The findings pertaining to hemobilia etiology, investigation, and management techniques were considered and organized by clinicians practiced in hemobilia. Results: The majority of current hemobilia cases have an iatrogenic cause from either bile duct or liver manipulation. Blunt trauma is also a significant cause of hemobilia. The classic triad presentation of right upper quadrant pain, jaundice, and upper gastrointestinal bleeding is rarely seen. Computed tomography and magnetic resonance imaging are the preferred diagnostic modalities, and the preferred therapeutic management includes interventional radiology and endoscopic retrograde cholangiopancreatography. Surgery is rarely a therapeutic option. Conclusions: With advances in computed tomography and magnetic resonance imaging technology, diagnosis with these less invasive investigations are the favored option. However, traditional catheter angiography is still the gold standard.

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The endoscopic retrograde cholangiopancreatography ERCP showed, images suggesting intraductal choledocus polyps, as well as dilation of choledocus and intrahepatic bile ducts, being subjected to surgery exploration observing polyps in the left hepatic duct, taking a biopsy that reported intraepitelial adenoma Figure 1. One patient died from aggravating hepatic encephalopathy as a complication of liver cirrhosis. Endoscopic management of obstructive jaundice caused by hemobilia. The clinical features of hemobilia were jaundice In conclusion, hemobilia is a rare cause of upper GI bleed. This article is published under license to BioMed Central Ltd. It can be immediately life-threatening in major bleeding. About this article Cite this article Zaydfudim, V. Print Send to a friend Export reference Mendeley Statistics. Acta Chir Belg.

Haemobilia is a medical condition of bleeding into the biliary tree.

Sandblom P, Mirkovitch V. Hemobilia refers to the presence of blood in the biliary tree. Biliary catheter drainage complicated by hemobilia: treatment by balloon embolotherapy. ERCP has played important roles in the diagnosis of hemobilia. Full size image. Inicio Annals of Hepatology Hemobilia. Postgrad Med J , — In the past, the most common cause of hemobila was accidental trauma, followed by iatrogenic injury, such as liver biopsy or percutaneous transhepatic cholangiography PTC. Similar to the vascular bleeding complications after pancreaticoduodenectomy, clinically significant hemobilia can occur when a post-operative organ space infection develops in the presence of a disrupted or reconstructed biliary tree and surgically altered vascular system or an unrecognized injury to the hepatic vasculature. Hemobilia from a hepatic artery source frequently requires transcatheter embolization via a right femoral artery approach or even hepatic artery ligation, which can result in liver failure in patients with underlying hepatic insufficiency. Export reference.