Hemobilia: Historical overview, clinical update, and current practices

Abstract

Hemobilia refers to macroscopic blood in the lumen of the biliary tree. It represents an uncommon, but important, cause of gastrointestinal bleeding and can have potentially lethal sequelae if not promptly recognized and treated. The earliest known reports of hemobilia date to the 17th century, but due to the relative rarity and challenges in diagnosis of hemobilia, it has historically not been well‐studied. Until recently, most cases of hemobilia were due to trauma, but the majority now occur as a sequela of invasive procedures involving the hepatopancreatobiliary system. A triad (Quincke's) of right upper quadrant pain, jaundice and overt gastrointestinal bleeding has been classically described in hemobilia, but it is present in only a minority of patients. Therefore, prompt diagnosis depends critically on a high index of suspicion based on a patient's clinical presentation and a history of recently undergoing hepatopancreatobiliary intervention or having other predisposing factors. Treatment of hemobilia depends on the suspected source and clinical severity and thus ranges from supportive medical care to urgent advanced endoscopic, interventional radiologic, or surgical intervention. In the present review, we provide a historical perspective, clinical update and overview of current trends and practices pertaining to hemobilia.

Diagnosis and Management of Iatrogenic Hemobilia Secondary to Transjugular Intrahepatic Portosystemic Shunt Procedure

“…Iatrogenic hemobilia may occur as a result of hepato-biliary procedures. Given the close proximity of bile duct radicals to the branches of the hepatic artery and portal vein, the incidence of concurrent injury to these structures and consequent fistula formation is not unexpected [5][6][7]. A 3.8% incidence of hepatic vascular abnormalities was found following percutaneous transhepatic cholangiography, a 5.4% incidence of hepatic vascular abnormalities following percutaneous liver biopsy, and a 26.2% incidence following the placement of indwelling transhepatic drainage catheters [8][9].…”

Safra kesesi kanserine bağlı gelişen hemobilinin başarılı tedavisi

“…Bilgisayarlı tomografi ve manyetik rezonans görüntüleme tercih edilen tanı yöntemleridir (3). Tercih edilen tedavi yöntemleri ise transkatater arteryal embolizasyon ve endoskopik olarak kanama kontrolünün sağlanmasıdır (4). Cerrahi nadiren terapötik bir seçenektir.…”

Hemobilia after bile duct resection: perforation of pseudoaneurysm into intra-pancreatic remnant bile duct: a case report

“…Hemobilia is defined as the extravasation of blood into the biliary tract. It is one of the morbidities related to hepato-biliary-pancreatic surgery, and ranges from minor to severe bleeding, which is life-threatening [1,2]. The main cause of hemobilia is iatrogenic, such as impairment of the right hepatic or cystic artery, and bile duct [2].…”

“…It is one of the morbidities related to hepato-biliary-pancreatic surgery, and ranges from minor to severe bleeding, which is life-threatening [1,2]. The main cause of hemobilia is iatrogenic, such as impairment of the right hepatic or cystic artery, and bile duct [2]. A pseudoaneurysm of the gastroduodenal artery (GDA) is known to cause hemobilia due to common bile duct perforation [3].…”