2021, Number 2
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Rev cubana med 2021; 60 (2)
Hemobilia as a rare and serious cause of upper gastrointestinal bleeding
Pérez MR, García AMJ, Obregón MA
Language: Spanish
References: 17
Page: 1-7
PDF size: 239.13 Kb.
ABSTRACT
Introduction:
Hemobilia is, by definition, a cause of upper gastrointestinal bleeding, where there is a communication of the bile duct in any of its segments with blood vessels that flow through the ampulla of Vater. It is rare and it is not suspected in the daily clinical practice of gastroenterologists, surgeons, hepatologists, clinicians and intensivists, hence the diagnostic-therapeutic management is difficult and it has high morbidity and mortality.
Objective:
To report three cases of patients with a diagnosis of hemobilia.
Case report:
We report three cases of hemobilia of high mortality and different etiology. The first case had post-liver transplantation hepatic artery thrombosis, the second had asecondary cholangiocarcinoma of the hepatocystic junction and the third had diagnosis of confirmed right hepatic artery aneurysm partially treated by CT angiography, subsequently operated on and the only survivor.
Conclusions:
These three hemobilia cases had different causes, and high mortality due to the intensity of the upper gastrointestinal bleeding and the associated comorbidities, in addition to noting that none of them exhibited the classic triad reported by Quincke.
REFERENCES
Glisson F. Anatomía hepatis. Cap. 1 en Anatomia Hepatis. London: O. Pullein; 1954. p. 44-63.
Chin MW, Enns R. Hemobilia. Curr Gastroenterol Rep. 2010;12:121-9. https://doi.org/10.1007/s11894-010-0092-5
Sandblom P. Hemorrhage into the biliary tract following trauma; traumatic hemobilia. Surgery. 1948;24(3):571-86.
Asensio L, Álvarez E, Rodríguez-Montes JA. Hemobilia: una complicación poco común de la colecistectomia. J Neg No Positive Resul. 2017;2(4):160-4. https://doi.org/10.19230/jonnpr.1307
Jones PM, Subbarao G. Hemobilia caused by hepatic artery pseudoanerysm following abdominal trauma. J Pediatr Gastroenterol Nutr. 2015;60:40. https://doi.org/10.1097/MPG.0b013e31829ce596
Lee YT, Lin H, Chen KY, Wu HS, Hwang MH, Yan SL. Life-threatening hemobilia caused by hepatic pseudoaneurysm after T-tube choledochostomy: report a case. BMC Gastroenterol. 2010;10:81-84. https://doi.org/10.1186/1471-230X-10-81
Kirklin J.W. Treatment of aneurism of the hepatic artery by excision: Report of a case. Ann Surq. 1955;142:110-14. https://doi.org/10.1097/00000658-195507000-00014
Berry R, Han JY, Kardashian AA, La Russo NF, Tabibian JH. Hemobilia: Etiology, diagnosis, and treatment. Liver Res. 2018[acceso: 05/05/2020];2(4):200-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31308984/
Panno C, Gutíerrez S, Echevarría R. Hemobilia secundaria a pseudoaneurisma de la arteria hepática. Acta Gastroenterol Latinoam. 2015[acceso: 05/05/2020];45(2):133-36. Disponible en: http://www.scielo.org.co/pdf/rcg/v32n2/0120-9957-rcg-32-02-00171.pdf
Arroja B, Canhoto M, Barata P, Goncalves C, Silva F, Cotrim I, et al. Hemobilia after pseudoaneurysm of hepatic artery branch. Rev Esp Enferm Dig. 2010;102:386-7. https://doi.org/10.4321/s1130-01082010000600009
Merrett ND, Cosman P, Biankin AV. Education of imaging. Hepatobiliary and pancreatic: iatrogenic hemobilia. J Gastroenterol Hepatol. 2008;23:821-22. https://doi.org/10.1111/j.1440-1746.2008.05450.x
Hernández-González R. Hemobilia: un caso, complicaciones, seguimiento. Cir Ciruj. 2003[acceso: 05/05/2020];71:137-44. Disponible en: https://www.medigraphic.com/pdfs/circir/cc-2003/cc032j.pdf
Bin Traiki TA, Madkhali AA, Hassanian MM. Hemobilia post-laparoscopic cholecystectomy. J Surg Case Rep. 2015;2:1-3. https://doi.org/10.1093/jscr/rju159
Takahiro A, Yuma T, Motoya T, Hiroki S, Hisato H, Satoshi H. Hemobilia a-rare complication after laparoscopic cholecystectomy. Surgical Case Report. 2020;6(91):1-6. https://doi.org/10.1186/540792-020-00837.6
Navuluri R. Hemobilia. Semin Intervent Radiol. 2016;33(4):324-31. https://dx.doi.org/10.1055/s-0036-1593321
Gerson LB, Fidler JL, Cave DR. Clinical guideline: diagnosis and management of small bowel bleeding. Am J Gastroenterol. 2015;110(9):1265-87. https://doi.org/10.1038/ajg.2015.246
Berry R, Han J, Girotra M, Tabibian JH. Hemobilia: Perspective and Role of the Advanced Endoscopist. Gastroenterol Res Pract. 2018. https://doi.org/10.1155/2018/3670739