Endoscopic Management of Traumatic Hemobilia

Singh, Virendra

doi:10.1097/01.ta.0000246881.67799.4f

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…Surgical procedures still play an important role in the management of patients with unstable hemodynamics or failure following selective angiographic embolization (22,27,36,50,59). A flowchart (Figure 3) was recommended to provide a suitable approach to deal with this rare but life-threatening condition in accordance with the literature (15,17,33,36,46,50,52,(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64) and our preliminary experience.…”

Section: Discussionmentioning

confidence: 77%

“…Conservative management includes fluid resuscitation, blood transfusion, correction of coagulopathy, and adequate drainage (36). Endoscopic nasobiliary drainage without sphincterotomy is an optimal method to treat traumatic hepatobiliary injuries in patients with stable hemodynamics (57). Hemobilia may stop because of blood clot formation after the diversion of bile with nasobiliary drainage (57).…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic nasobiliary drainage without sphincterotomy is an optimal method to treat traumatic hepatobiliary injuries in patients with stable hemodynamics (57). Hemobilia may stop because of blood clot formation after the diversion of bile with nasobiliary drainage (57). Selective transcatheter arterial embolization as a useful therapeutic method for traumatic hepatic pseudoaneurysm and/or its rupture into the biliary duct remains the first-line choice for the majority of cases (17,31,35,36,39,40,50,55,58), with 26/35 (74.28%) of patients undergoing successful angiographic embolization, as shown in Table 1.…”

Section: Discussionmentioning

confidence: 99%

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Severe Blunt Liver Injury Complicated by Delayed Massive Hemobilia in a Toddler: A Case Report and Literature Review

Liu

Sun

et al. 2022

Front. Surg.

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IntroductionUnintentional injuries remain a leading cause of disability among children. Although most of the pediatric patients suffering blunt liver injury can be successfully treated with non-operative therapy, the diagnosis and management of delayed life-threatening hemobilia following severe blunt liver injury, especially in the pediatric population, remain a challenge for clinicians.Case PresentationA previously healthy 2-year-old girl suffered a severe blunt liver injury related to an electric bike, which was inadvertently activated by herself. She initially received non-operative therapy and was in a stable condition in the first 2 weeks. On the 16th and 22nd postinjury days, the patient presented with life-threatening massive hemobilia, which was confirmed via repeat emergent gastroscopy and hepatic arterial angiography. An emergency selective transarterial embolization of the involved branch of the left hepatic artery was successfully performed. The patient recovered uneventfully, and long-term follow-up was needed owing to a mild dilatation of the left intrahepatic bile duct.DiscussionIncidental injury in children should be considered as a major public health issue and preventive measures should be taken to reduce its occurrence. Delayed massive hemobilia after severe blunt liver trauma is rare, and its accurate and timely diagnosis via emergency hepatic arterial angiography and selective angioembolization may allow prompt and optimal management to achieve good outcomes in the pediatric population.

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