Hemobilia:Etiology,diagnosis,and treatment
10.1016/j.livres.2018.09.007
- Author:
Berry RANI
1
;
Han JAMES
;
A.Kardashian ANI
;
F.LaRusso NICHOLAS
;
H.Tabibian JAMES
Author Information
1. Department of Internal Medicine
- Keywords:
Hemobilia;
Upper gastrointestinal hemmorhage;
Etiology;
Diagnosis;
Imaging;
Hepatopancreatobiliary interventions
- From:
Liver Research
2018;2(4):200-208
- CountryChina
- Language:Chinese
-
Abstract:
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 rep-resenting 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 eti-ology,diagnosis,and treatment of hemobilia geared for specialists and subspecialists alike.
