Haemobilia

Green, M H A; Duell, Rebecca; Johnson, C. Daniel; Jamieson, Neville V.

doi:10.1046/j.1365-2168.2001.01756.x

Cited by 245 publications

(291 citation statements)

References 143 publications

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“…Bu hastada da klasik triad izlenmiştir. Ancak bu triad hastaların yaklaşık beşte birinde ortaya çıkar (7). Gastrointestinal kanama en sık görülen klinik bulgudur.…”

Section: Discussionunclassified

Hemobilia due to A Tubulopapillary Adenoma of the Gallbladder

Tardu¹,

Yağcı²,

Karagül³

et al. 2016

Istanbul Med J

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“…Bu hastada da klasik triad izlenmiştir. Ancak bu triad hastaların yaklaşık beşte birinde ortaya çıkar (7). Gastrointestinal kanama en sık görülen klinik bulgudur.…”

Section: Discussionunclassified

Hemobilia due to A Tubulopapillary Adenoma of the Gallbladder

Tardu¹,

Yağcı²,

Karagül³

et al. 2016

Istanbul Med J

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“…Accidental trauma used to be the major cause of hemobilia. Currently, two-thirds of hemobilia are caused by iatrogenic trauma, which has been rapidly increasing with the frequent applications of percutaneous hepatic and biliary procedures such as liver biopsy and percutaneous biliary drainage [2]. In contrast, non-traumatic hemobilia due to infl ammation, gallstone, and vascular malformations are extremely rare and also diffi cult to be diagnosed compared to traumatic hemobilia.…”

Section: Introductionmentioning

confidence: 99%

“…Hemobilia occurs when there is a communication between a vessel and the intrahepatic or extrahepatic biliary system and is typically represented as Quincke's triad: colicky abdominal pain, jaundice, and gastrointestinal hemorrhage [2]. The etiology of hemobilia includes iatrogenic trauma, accidental trauma, gallstones, infl ammation, vascular malformations and tumors.…”

Section: Introductionmentioning

confidence: 99%

Report of a Case: Pseudoaneurysm of the Cystic Artery With Hemobilia Treated by Arterial Embolization

Komatsu

2011

J Med Cases

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We report a case of hemobilia caused by pseudoaneurysm of the cystic artery in a 71-year-old woman who presented with fever and epigastric colicky pain with jaundice. Liver function tests showed signs of obstructive jaundice. On the second day, patient had a massive hematemesis and melena with hypovolemic shock. Hemobilia was diagnosed by endoscopically visualizing bleeding from the papilla of Vater. An emergent angiography demonstrated the presence of a pseudoaneurysm in the cystic artery. Selective embolization of the cystic artery was then performed to interrupt the blood fl ow into the pseudoaneurysm. Immediately after embolization, patient was hemodynamically stabilized. Although the patient did not undergo cholecystectomy after embolization due to severe co-morbidities, no signs of ischemic gallbladder have been observed. Hemobilia should be included in the differential diagnosis of upper gastrointestinal bleeding with unknown etiology. Embolization could be an option for pseudoaneurysms of the cystic artery especially in highrisk patients.

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“…There was no evidence of acute pancreatitis. review carried out by Green et al 1 between 1996 and 1999 identified only 222 cases of confirmed haemobilia of which about 11 cases were thought to be secondary to gallstone haemorrhagic cholecystitis. Haemorrhagic cholecystitis may result in upper GI tract bleeding with haematemesis or melaena.…”

Section: Autopsy Findingsmentioning

confidence: 99%

An unusual case of jaundice in secondary diabetes

Reynolds

Laidlaw

et al. 2003

Pract Diab Int

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A 66-year-old insulin-requiring diabetic male with diabetes secondary to pancreatic damage from alcohol abuse, with well-established alcoholic liver disease and cirrhosis, developed obstructive jaundice from gall stones and later from a biliary stricture associated with gram-negative septicaemia. Death occurred from a haemorrhagic cholecystitis with ruptured gall bladder. At autopsy, a surprise finding was a non-functioning pancreatic islet cell tumour invading the ampulla of Vater. Cholestasis in this case was due to multiple factors. Copyright Autopsy findingsThe main post-mortem findings were a markedly dilated, haemorrhagic, inflamed perforated gallbladder filled with blood-stained bile and containing multiple small mixed stones with some gravel. The wall of the gall-bladder was diffusely haemorrhagic, almost gangrenous, inflamed and had perforated along the inferior surface of the fundus. The perforation was 3-4mm in maximum dimension (Figures 1 and 2). The common bile duct was markedly dilated, contained multiple small mixed stones, each a few millimetres and a 7cm long plastic stent, extending from the ampulla to the junction of the right and left hepatic bile duct. The plastic stent was in situ and with no local complications. There was no perforation or rupture of the common bile duct. The perforated acute haemorrhagic cholecystitis was accompanied by localised peritonitis but there was no macroscopic evidence of generalised peritonitis.The liver was deeply green and cirrhotic with a fine nodular cut surface (Figures 3 and 4). The head of the pancreas was mostly occupied by an ill-defined firm and scirrhous tumour, histologically proven to be an islet cell tumour (Figures 5 and 6). The tumour at the head of the pancreas has obstructed the junction of the common bile duct and main pancreatic duct as they join to form the ampulla of Vater. There was no evidence of regional lymph node, liver or lung metastases. The distal part of the main pancreatic duct contained a 1.8cm calculus accompanied by features of chronic pancreatitis. There was no evidence of acute pancreatitis. Discussion CLINICO-PATHOLOGICAL CONFERENCE An unusual case of jaundice in secondary diabetes IN:Perforation of the gall-bladder can also occur due to gallstones without predisposing haemorrhagic cholecystitis.SRL: This is so but gall-bladder perforation secondary to gallstones is very uncommon. A retrospective audit carried out at UCLA affiliated hospitals identified only 51 confirmed cases over a 27-year period. 3 RMR: It would appear that this patient had five possible causes of his jaundice.IWC: That is correct and these are summarised in Table 2. It is important in any patient, diabetic or non-diabetic, to always consider more than one cause as these different aetiologies may co-exist. IN:In my pathological experience it is very unusual to have so many causes, some rare, in one patient.SRL: Why does septicaemia cause jaundice?IWC: Patients with sepsis often develop cholestasis due to the activation of inflammatory cyto...

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Haemobilia

Cited by 245 publications

References 143 publications

Hemobilia due to A Tubulopapillary Adenoma of the Gallbladder

Hemobilia due to A Tubulopapillary Adenoma of the Gallbladder

Report of a Case: Pseudoaneurysm of the Cystic Artery With Hemobilia Treated by Arterial Embolization

An unusual case of jaundice in secondary diabetes

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