Fatal bilhemia

Sandblom, P; Jakobsson, B; Lindgren, Hans; Lunderquist, Anders

doi:10.1067/msy.2000.103488

Cited by 23 publications

(19 citation statements)

References 19 publications

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“…In a series of 20 patients with biliary leaks (four with bilhemia), endoscopic sphincterotomy successfully managed all patients but one who died of bile thromboembolism [9] . In the event of a higher location or lack of available technical expertise for ERCP, percutaneous drainage of the biliary system is an alternative [8] . Unfortunately, if the shunt is infected, liver transplantation is the only option to salvage these patients as when the TIPS is placed it can not be removed [5,7] .…”

Section: B Amentioning

confidence: 99%

“…ERCP is the most useful tool to diagnose this condition as it follows the direction of flow across the fistula [8] . Scintigraphy may be used if endoscopic expertise is unavailable [8] .…”

Section: B Amentioning

confidence: 99%

“…To our knowledge, this is the first report of portal vein-biliary fistula causing bilhemia and presenting with rapidly rising bilirubin within 48 h of the TIPS procedure. This condition can be lethal in about 50% of cases, mostly due to fat embolism from a sudden gush of un-dissolved bile into the bloodstream [4,8] . ERCP is the most useful tool to diagnose this condition as it follows the direction of flow across the fistula [8] .…”

Section: B Amentioning

confidence: 99%

“…This condition can be lethal in about 50% of cases, mostly due to fat embolism from a sudden gush of un-dissolved bile into the bloodstream [4,8] . ERCP is the most useful tool to diagnose this condition as it follows the direction of flow across the fistula [8] . Scintigraphy may be used if endoscopic expertise is unavailable [8] .…”

Section: B Amentioning

confidence: 99%

See 3 more Smart Citations

Bilhemia after trans-jugular intra-hepatic porto-systemic shunt and its management with biliary decompression

Singal

Kathuria

Malhotra

et al. 2009

WJG

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Bilhemia or bile mixing with blood is a rare clinical problem. The clinical presentation is usually transient self-resolving hyperbilirubinemia, progressive and rapidly rising conjugated hyperbilirubinemia, or recurrent cholangitis. Endoscopic retrograde cholangiopancreatography (ERCP) plays an important role in diagnosis and management. Biliary decompression with endoscopic sphincterotomy is useful in treating these patients. If not recognized and treated in time, the condition can be fatal in a significant proportion of patients. This usually occurs after blunt or penetrating hepatic trauma due to a fistulous connection between the biliary radicle and portal or hepatic venous radical. Cases have been described due to iatrogenic trauma such as liver biopsy and percutaneous biliary drainage. However, the occurrence after trans-jugular intra-hepatic porto-systemic shunt (TIPS) is very rare. We report a case of bilhemia presenting as rapidly rising bilirubin after TIPS. The patient was managed successfully with ERCP and removal of a blood clot from the common bile duct.

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Section: B Amentioning

confidence: 99%

“…ERCP is the most useful tool to diagnose this condition as it follows the direction of flow across the fistula [8] . Scintigraphy may be used if endoscopic expertise is unavailable [8] .…”

Section: B Amentioning

confidence: 99%

Section: B Amentioning

confidence: 99%

Section: B Amentioning

confidence: 99%

See 2 more Smart Citations

Bilhemia after trans-jugular intra-hepatic porto-systemic shunt and its management with biliary decompression

Singal

Kathuria

Malhotra

et al. 2009

WJG

View full text Add to dashboard Cite

show abstract

“…In the very few reported cases, patients presented with hemodynamic instability, thus precluding non-invasive treatment [1][2][3][4][5][6][7]. Because of its rarity, the optimal management of bilhemia on hemodynamical stable patients is not consensual [8].…”

Section: Introductionmentioning

confidence: 99%