Hemobilia Secondary to Transjugular Intrahepatic Portosystemic Shunt Procedure: A Case Report

Kaswala, Dharmesh; Gandhi, Divyang; Moroianu, Andrew; Patel, J C; Patel, Nitin; Klyde, David; Brelvi, Zamir

doi:10.3390/jcm1010015

Cited by 10 publications

(9 citation statements)

References 14 publications

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“…Angiography is clearly the most efficacious method for controlling intrahepatic bleeding sources, with success rates above 95%. A complication of embolization includes hepatobiliary necrosis (6%), abscess formation (9%), bleeding (6%), and gallbladder fibrosis (2%) [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

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

Puntel

Puppini

Perandini

et al. 2020

Cureus

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A patient with end-stage liver disease and subsequent refractory ascites was treated with a transjugular intrahepatic portosystemic shunt (TIPS) procedure. The procedure was complicated by massive gastrointestinal hemorrhage with associated rettorragia. Computed tomography angiography (CT-A) was performed and revealed haemobilia due to an arterobiliary fistula between the right hepatic artery and an intrahepatic biliary branch. The patient underwent an attempt at percutaneous embolization. Bleeding was successfully stopped by the embolization of the fistula with coils. Hemobilia is a rare cause of upper gastrointestinal bleeding with an increasing incidence due to the widespread use of invasive hepatobiliary procedures. Hemobilia is an uncommon complication of TIPS procedures. Nowadays, transcatheter embolization is the gold standard in the management of hemobilia.

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Section: Discussionmentioning

confidence: 99%

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

Puntel

Puppini

Perandini

et al. 2020

Cureus

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“…Other percutaneous interventions which can result in hemobilia include transjugular intrahepatic portosystemic shunt (TIPS) . While a relatively high‐risk procedure, it makes up a fairly small proportion of percutaneous intervention‐related hemobilia cases.…”

Section: Causes Of Hemobiliamentioning

confidence: 99%

Hemobilia: Historical overview, clinical update, and current practices

Zhornitskiy

Berry

Han

et al. 2019

Liver International

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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.

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“…Other interventional procedures which may result in hemobilia include ultrasound-guided radiofrequency ablation, transarterial chemoembolization, and transjugular intrahepatic portosystemic shunt placement. 20–22 Though potentially high risk, these interventions collectively comprise a much smaller proportion of cases due to their relative rarity.…”

Section: Causes Of Hemobiliamentioning

confidence: 99%

Hemobilia: Etiology, diagnosis, and treatment

Berry

Han

Kardashian³

et al. 2018

Liver Research

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Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon but important cause of gastrointestinal hemorrhage. Reports of hemobilia date back to the 1600s, but due to its relative rarity and challenges in diagnosis, only in recent decades has hemobilia been more critically studied. The majority of cases of hemobilia are iatrogenic and caused by invasive procedures involving the liver, pancreas, bile ducts and/or the hepatopancreatobiliary vasculature, with trauma and malignancy representing the two other leading causes. A classic triad of right upper quadrant pain, jaundice, and overt upper gastrointestinal bleeding has been described (i.e. Quincke’s triad), but this is present in only 25%–30% of patients with hemobilia. Therefore, prompt diagnosis depends critically on having a high index of suspicion, which may be based on a patient’s clinical presentation and having recently undergone (peri-) biliary instrumentation or other predisposing factors. The treatment of hemobilia depends on its severity and suspected source and ranges from supportive care to advanced endoscopic, interventional radiologic, or surgical intervention. Here we provide a clinical overview and update regarding the etiology, diagnosis, and treatment of hemobilia geared for specialists and subspecialists alike.

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Hemobilia Secondary to Transjugular Intrahepatic Portosystemic Shunt Procedure: A Case Report

Cited by 10 publications

References 14 publications

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

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

Hemobilia: Historical overview, clinical update, and current practices

Hemobilia: Etiology, diagnosis, and treatment

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