hemobilia | pacs

Teenager with

abdominal pain after liver biopsy. Transverse (above) and sagittal (below) US of the gallbladder show it to be diffusely filled with echogenic material.The diagnosis was hemobilia as a complication from liver biopsy.

pediatricimaging.org • CC-by-nc-sa 4.0

A case of

biliary cystic tumor with repeated hemobilia. Abdominal contrast computed tomography (post-transcatheter arterial embolization [TAE]) and magnetic resonance imaging findings. (a) Computed tomography scan showed a low-density hepatic lesion measuring 15 cm in diameter with mural nodules. These nodules were contrast-enhanced. The TAE coils were observed. (b) T1-weighted image showed a low-intensity mass, except for the mural nodules. (c) T2-weighted image demonstrated high signals from the mural nodules.

surgicalcasereports.springeropen.com • CC-by-4.0

A case of

biliary cystic tumor with repeated hemobilia. Transcatheter arterial embolization sequence as shown in a right hepatic angiography. The angiography also demonstrated hypervascular lesions in the cystic tumor.

surgicalcasereports.springeropen.com • CC-by-4.0

Case report:

acute pancreatitis caused by postcholecystectomic hemobilia. pseudoaneurysm.

bmcgastroenterol.biomedcentral.com • CC-by-2.0

Radiopaedia • CC-by-nc-sa 3.0 • de

Hemobilia refers to the presence of blood in the biliary tree.

Clinical presentation

The classical clinical triad, only seen in ~50% of cases, consists of:

melena (i.e. upper gastrointestinal bleeding)

jaundice

abdominal pain

Pathology

Etiology

iatrogenic: surgical or percutaneous procedures (~67%)
trauma (~5%)
- associated with pseudoaneurysm formation from central liver trauma
- may manifest several (2-4) weeks after the initial injury
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