Hemobilia refers to the presence of blood in the biliary tree.
The classical clinical triad, only seen in ~50% of cases, consists of:
- iatrogenic: surgical or percutaneous procedures (~67%)
- trauma (~5%)
- vascular malformations (7%)
- e.g. hepatic artery aneurysm or arteriovenous malformation
- can cause massive hemobilia
- malignancy (e.g. hepatocellular carcinoma - most common, gallbladder metastases)
- abscess formation
- gastrointestinal bleed due to gallstones
Ultrasound is often the first investigation and reveals echogenic material in the bile ducts and dilated gallbladder.
- high-attenuation clot within the bile ducts