Radiofrequency ablation (RFA) has been accepted as a safe and effective treatment for unresectable hepatic tumors because of the advantages of a minimally invasive procedure and the local treatment effect. Although RFA can be performed safely in most patients, early and late complications related to mechanical or thermal damage may be observed at follow-up examination. Hemobilia is a very rare complication of RFA and most hemobilia is an immediate complication. However, delayed hemobilia is an even more rare complication after RFA and is known to be a fatal complication. We present a case of delayed fatal hemobilia after RFA for hepatocellular carcinoma.
Carcinoma, Hepatocellular ; Follow-Up Studies ; Hemobilia ; Humans

Anticoagulation therapy is essential after cardiac valve surgery. However, spontaneous bleeding remains a major concern during anticoagulation therapy. Spontaneous gallbladder (GB) hemorrhage (hemobilia) is a rare occurrence during standard anticoagulation therapy. This report presents a case of GB hemorrhage that occurred shortly after initiating oral anticoagulant therapy in a patient who had undergone mitral valve replacement surgery.
Anticoagulants ; Gallbladder* ; Heart Valves* ; Hemobilia ; Hemorrhage* ; Humans ; Mitral Valve

Transcatheter arterial embolization was applied in 7 cases of hepatic disease including hemobilia of various causes and malignant tumors at Department of Radiology, Seoul National University Hospital during recent several years. The embolic materials were autologous blood clot and Gelfoam particle. Successful control of bleeding or devascularization of tumor vessel was made in 6 of the 7 patients. There was no serious complications; however, post embolization syndrome was found including pain, fever, nausea and vomiting in all cases and subsided after a few days. Transcatheter hepatic arterial embolization is suggested to be a safe and effective treatment in control of hemobilia and devascularization of malignant hepatic tumors.
Fever ; Gelatin Sponge, Absorbable ; Hemobilia ; Hemorrhage ; Humans ; Nausea ; Seoul ; Vomiting

Hemobilia is a cause of obscure gastrointestinal hemorrhage. Most cases have an iatrogenic or traumatic origin but cases of hemobilia with non-traumatic causes are rare. The non-traumatic causes of hemobilia are inflammation, gallstones, neoplasm and vascular lesions. Currently, various therapeutic options are available for hemobilia, and transarterial embolization is now the first line of intervention used to stop the bleeding of hemobilia, which shows a high success rate of approximately 80% to 100% with a lower morbidity and mortality rate than with surgery. We report a rare case of non-traumatic hemobilia caused by a pseudoaneurysm of the hepatic artery that was successfully treated with transarterial embolization.
Aneurysm, False* ; Gallstones ; Gastrointestinal Hemorrhage ; Hemobilia* ; Hemorrhage ; Hepatic Artery* ; Inflammation ; Mortality

Cholangiocarcinoma is a rare tumor among all populations of the world and accounts for less than 2% of cancers found at autopsy and between 10% and 20% of all primary liver cancers. The tumor originates either from the intrahepatic small duct radicles(peripheral type) or the major hepatic ducts at or near the junction of the right and left hepatic ducts(hilar type). Included in the latter are the small intraduct carcinomas arising at the bifurcation of the hepatic ducts. (continue...)
Autopsy ; Cholangiocarcinoma* ; Cholangiopancreatography, Endoscopic Retrograde ; Hemobilia* ; Hepatic Duct, Common ; Humans ; Jaundice, Obstructive* ; Liver Neoplasms

Hemobilia is a hemorrhage into the biliary tract and is a relatively rare cause of bleeding in the digestive tract. Gallbladder cancer is the most common tumor in the biliary tract. Gastrointestinal bleeding including hemobilia is reported in only 3% of cases of gallbladder cancer. Here, we report two rare cases of gallbladder cancer diagnosed by the detection of hemobilia. One case was an anemic patient with no abnormal endoscopic findings; capsule endoscopy showed blood in the duodenum and repeat gastroendoscopy revealed hemorrhage from the ampulla of Vater. The diagnosis of early gallbladder cancer was made and the patient underwent surgery and was followed-up. The other case presented with a symptom triad including hemobilia, and endoscopic retrograded cholangiopancreatography (ERCP) revealed hemobilia and a filling defect in the gallbladder. This patient also underwent radical cholecystectomy with the diagnosis of gallbladder cancer.
Ampulla of Vater ; Biliary Tract ; Capsule Endoscopy ; Cholecystectomy ; Duodenum ; Gallbladder ; Gallbladder Neoplasms ; Gastrointestinal Tract ; Hemobilia ; Hemorrhage ; Humans

No abstract available.
Aged, 80 and over ; Cholecystitis/*complications/diagnosis ; Hemobilia/diagnosis/*etiology ; Humans ; Jaundice, Obstructive/etiology ; Male

"Hemobilia" upper gastrointestinal bleeding that originates from within the biliary tract, is a rare complication of the laparoscopic cholecystectomy. Only a few cases have been reported in the literature. It is more common in accidential or iatrogenic injury of the liver and bile ducts, even occurring spontaneously in cholelithiasis, several inflamatory processes, and vascular and neoplastic changes. The laparoscopic cholecystectomy is a recently developed and advanced surgical procedure that has rapidly gained acceptance. Its complications remain to be clinically analyzed. The authors experienced a case of massive hemobilia after a laparoscopic cholecystectomy. A 54-years-old man with hemobila resulting from right hepatic artery pseudoaneurysm communicating with the intra-hepatic bile duct was treated with angiographic tanscatheter embolization on the of 24th postoperative day. We report this case with a brief review of the literature.
Aneurysm, False ; Bile Ducts ; Biliary Tract ; Cholecystectomy, Laparoscopic* ; Cholelithiasis ; Hemobilia* ; Hemorrhage ; Hepatic Artery ; Liver

Biliary plastic stent induced life-threatening hemobilia is very rare. In this case, hemobilia seriously worsened following removal of a biliary stent, which had been placed for treatment of a postoperative bile leak in a patient who had undergone lateral liver segmentectomy for abdominal trauma. Following placement of the biliary stent, the bile leak improved, but hemobilia and cholangitis developed five days later. To manage the stent malfunction, we removed the biliary stent. However, life-threatening hemobilia developed immediately after removal. Endoscopic hemostasis was impossible; therefore, emergency angiographic embolization and stent graft were performed successfully. In such cases, angiographic embolization and stent-graft placement are effective diagnostic and therapeutic alternatives. When a patient develops hemobilia or cholangitis after biliary stent placement, endoscopists should pay special attention to remove the stent, which might exacerbate hemobilia.
Angiography ; Bile* ; Blood Vessel Prosthesis ; Cholangitis ; Emergencies ; Hemobilia* ; Hemostasis, Endoscopic ; Humans ; Liver ; Mastectomy, Segmental ; Plastics ; Stents*

PURPOSE: To evaluate the difference in each procedure time and complication rates related to percutaneous transhepatic biliary drainage(PTBD) via the right and the left hepatic lobe. MATERIALS AND METHODS: We performed PTBD in 120 patients with biliary obstruction below both main hepatic ducts. Of the 120 catheters, 54 were introduced via a left lobe approach and 66 through the right lobe. All procedures were performed under fluoroscopic guidance by the same operator. For each patient, procedure time was recorded prospectively. PTBD related complications were classified as either early(up to 30 days after procedure) or late(after 30 days), and each complication graded as major, or minor according to its intensity. RESULTS: The difference in the mean procedure time(28.8min versus 36.2rain, left versus right approach group) and that in complication rates (37% versus 58%) were statistically significant(p<0.05). Concerning major complications(bile peritonitis, sepsis, massive hemobilia, liver abscess, pyothorax), the percentages related to left and right lobe approach were 1.8% and 10.6%, and concerning minor complications(catheter obstruction or dislodgement, transient hemobilia, persistent fever or pain), the percentages were 36%and 51%respectively. CONCLUSIONS: PTBD via the left lobe approach was superior with short procedure time and low complication rates than the right approach.
Catheters ; Fever ; Hemobilia ; Hepatic Duct, Common ; Humans ; Liver Abscess ; Peritonitis ; Prospective Studies ; Sepsis