Hemobilia

Kardashian, Nicholas F.

AoH publishes editorials, opinions, concise reviews, original articles, brief reports, letters to the editor, news from affiliated associations, clinical practice guidelines and summaries of congresses in the field of Hepatology. Our journal seeks to publish articles on basic clinical care and translational research focused on preventing rather than treating the complications of end-stage liver disease. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years. SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field. We present the case of a 88 years old male, with a history of melena, demonstrated by repeated endoscopys to be secondary to hemobilia, and after endoscopic retrograde cholangiopancreatography we could demonstrate the presence of bleeding intraductal choledocus polyps with histopathological report of intraepitelial adenoma.

Hemobilia

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. Percutaneous liver biopsy and transhepatic cholangiography are the most common causes of injury to the liver vasculature resulting in hemobilia. However, endoscopic interventions—such as probing of the bile duct with guidewires and deployment of self-expanding metal mesh biliary stents during endoscopic retrograde cholangiopancreatography ERCP —can also result in immediate or delayed bleeding. In addition, blunt or penetrating trauma to the liver can cause hemobilia. Indeed, the first description of hemobilia in the medical literature dates back to the middle of the 17th century when Francis Glisson found that a liver laceration sustained by a young man during a sword fight caused fatal biliary bleeding. Other causes of hemobilia include gallbladder and bile duct stones, biliary varices, biliary parasites eg, Ascaris lumbricoides , benign and malignant tumors involving the biliary tree, liver surgery including transplantation , congenital or acquired vascular aneurysms, pancreatitis, and hepatitis drug-induced or autoimmune. JB Typically, hemobilia causes melena or acute upper gastrointestinal bleeding of significant volume, which causes hemodynamic instability. A patient with hemobilia may experience acute biliary pain from distension of the bile ducts.

Received : 16 December Last revised:. Hemobilia a Gold Supporter and see no third-party ads.

Hemobilia is an uncommon medical problem that presents in a varied fashion and is increasingly of iatrogenic origin. The diagnosis of hemobilia needs to be considered in patients presenting with upper gastrointestinal bleeding, particularly if they are jaundiced with abdominal pain in the setting of recent or previous percutaneous liver intervention or abdominal trauma. Multislice computed tomographic angiography is increasingly being used in the investigation, but transcatheter arterial embolization remains the cornerstone of managing those patients requiring intervention. The majority of patients with hemobilia will be managed supportively or with radiologic intervention; most do not require surgical intervention. This is a preview of subscription content, log in via an institution to check access.

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.

Hemobilia

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. Percutaneous liver biopsy and transhepatic cholangiography are the most common causes of injury to the liver vasculature resulting in hemobilia. However, endoscopic interventions—such as probing of the bile duct with guidewires and deployment of self-expanding metal mesh biliary stents during endoscopic retrograde cholangiopancreatography ERCP —can also result in immediate or delayed bleeding.

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Today, transarterial embolization is the gold standard for the management of hemobilia, and if it fails, the next step in management is surgical, which is rarely ever needed. ERC shows characteristic filling defects in the biliary tree or gallbladder in most cases of hemobilia. Am J Gastroenterol , 59— Classification D. J Vasc Interv Radiol. OCLC Rights and permissions Reprints and permissions. View author publications. It is a rare cause of upper gastrointestinal bleeding. J Clin Gastroenterol Epub ahead of print. Gastrointest Endosc , Ann Vasc Surg.

Federal government websites often end in. The site is secure. Hemobilia is a rare source of upper gastrointestinal bleeding, though the incidence is increasing along with the rise in minimally invasive biliary interventions.

Provided by the Springer Nature SharedIt content-sharing initiative. Hepatocellular carcinoma presenting as intrabile duct tumor growth: a clinicopathologic study of 24 cases. Its occurrence is associated with other biliary complications, such as biliary leak or biloma. J Am Coll Surg. Typical symptoms in this scenario would be right upper quadrant pain, early satiety, and abdominal bloating [ 13 , 14 ]. Hemobilia from ruptured hepatic artery aneurysm in polyarteritis nodosa. Non-operative management of post-traumatic hemobilia with endovascular techniques is safe and effective regardless of the initial mechanism of injury or choice of management [ 16 , 17 ]. Management of nonocclusive hepatic artery complications after liver transplantation. Appropriate training, experience, and good technique by those performing invasive procedures, such as percutaneous transhepatic cholangiography and ERCP, help to minimize the risk of vascular injuries that can cause hemobilia. Articles: Quincke triad Gallbladder metastases Haemobilia Portal biliopathy Portal vein embolisation Liver biopsy transjugular Cystic artery pseudoaneurysm Segmental arterial mediolysis Cases: Cystic artery pseudoaneurysm Haemobilia Haemobilia Haemobilia. Reprints and permissions. The most common cholangiographic features were amorphous filling defects in 15 cases, followed by tubular filling defects in 6 cases, and cast-like filling defects in 6 cases Fig. See more.