TY - JOUR
T1 - Hemobilia
T2 - Etiology, diagnosis, and treatment
AU - Berry, Rani
AU - Han, James
AU - Kardashian, Ani A.
AU - LaRusso, Nicholas F.
AU - Tabibian, James H.
N1 - Publisher Copyright:
© 2019 The Third Affiliated Hospital of Sun Yat-sen University
PY - 2018/12
Y1 - 2018/12
N2 - Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon but important cause of gastrointestinal hemorrhage. Reports of hemobilia date back to the 1600s, but due to its relative rarity and challenges in diagnosis, only in recent decades has hemobilia been more critically studied. The majority of cases of hemobilia are iatrogenic and caused by invasive procedures involving the liver, pancreas, bile ducts and/or the hepatopancreatobiliary vasculature, with trauma and malignancy representing the two other leading causes. A classic triad of right upper quadrant pain, jaundice, and overt upper gastrointestinal bleeding has been described (i.e. Quincke's triad), but this is present in only 25%–30% of patients with hemobilia. Therefore, prompt diagnosis depends critically on having a high index of suspicion, which may be based on a patient's clinical presentation and having recently undergone (peri-) biliary instrumentation or other predisposing factors. The treatment of hemobilia depends on its severity and suspected source and ranges from supportive care to advanced endoscopic, interventional radiologic, or surgical intervention. Here we provide a clinical overview and update regarding the etiology, diagnosis, and treatment of hemobilia geared for specialists and subspecialists alike.
AB - Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon but important cause of gastrointestinal hemorrhage. Reports of hemobilia date back to the 1600s, but due to its relative rarity and challenges in diagnosis, only in recent decades has hemobilia been more critically studied. The majority of cases of hemobilia are iatrogenic and caused by invasive procedures involving the liver, pancreas, bile ducts and/or the hepatopancreatobiliary vasculature, with trauma and malignancy representing the two other leading causes. A classic triad of right upper quadrant pain, jaundice, and overt upper gastrointestinal bleeding has been described (i.e. Quincke's triad), but this is present in only 25%–30% of patients with hemobilia. Therefore, prompt diagnosis depends critically on having a high index of suspicion, which may be based on a patient's clinical presentation and having recently undergone (peri-) biliary instrumentation or other predisposing factors. The treatment of hemobilia depends on its severity and suspected source and ranges from supportive care to advanced endoscopic, interventional radiologic, or surgical intervention. Here we provide a clinical overview and update regarding the etiology, diagnosis, and treatment of hemobilia geared for specialists and subspecialists alike.
KW - Diagnosis
KW - Etiology
KW - Hemobilia
KW - Hepatopancreatobiliary interventions
KW - Imaging
KW - Upper gastrointestinal hemmorhage
UR - http://www.scopus.com/inward/record.url?scp=85075214939&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075214939&partnerID=8YFLogxK
U2 - 10.1016/j.livres.2018.09.007
DO - 10.1016/j.livres.2018.09.007
M3 - Review article
AN - SCOPUS:85075214939
SN - 2542-5684
VL - 2
SP - 200
EP - 208
JO - Liver Research
JF - Liver Research
IS - 4
ER -