Massive Bleeding Hemobilia Occurred in Patient with Hepatocellular Carcinoma.
- Author:
Kyung Eun LEE
1
;
Chang Wook KIM
;
Min Ju KIM
;
Jinhee PARK
;
Gu Min CHO
;
Jeong Won JANG
;
Young Sok LEE
;
Chang Don LEE
Author Information
- Publication Type:Case Reports ; English Abstract
- Keywords: Hemobilia; Carcinoma, hepatocellular; Gastrointestinal hemorrhage; Cholestasis
- MeSH: Aged; Bile Ducts, Extrahepatic; Bile Ducts, Intrahepatic; Bilirubin/analysis; Carcinoma, Hepatocellular/complications/*diagnosis/therapy; Duodenoscopy; Embolization, Therapeutic; Hemobilia/*etiology; Humans; Jaundice/etiology; Liver Cirrhosis/complications; Liver Neoplasms/complications/*diagnosis/therapy; Male; Severity of Illness Index; Thrombosis/diagnosis; Tomography, X-Ray Computed
- From:The Korean Journal of Gastroenterology 2013;61(1):46-49
- CountryRepublic of Korea
- Language:Korean
- Abstract: Massive bleeding hemobilia occurs rarely in patients with hepatocellular carcinoma (HCC) without any invasive procedure. Upper gastrointestinal bleeding in patient with cirrhosis and abdominal pain with progressive jaundice in patient with HCC were usually thought as variceal bleeding and HCC progression respectively. We experienced recently massive bleeding hemobilia in patient with HCC who was a 73-year old man and showed sudden abdominal pain, jaundice and hematochezia. He had alcoholic cirrhosis and history of variceal bleeding. One year ago, he was diagnosed as HCC and treated with transarterial chemoembolization periodically. Sudden right upper abdominal pain occurred then subsided with onset of hemotochezia. Computed tomography showed bile duct thrombosis spreading in the intrahepatic and extrahepatic ducts, while an ampulla of vater bleeding was observed during duodenoscopy. Hemobilia could be one of the causes of massive bleeding in patients with cirrhosis and HCC especially when they had sudden abdominal pain and abrupt elevation of bilirubin.
