Management of hemobilia associated with transhepatic internal biliary drainage catheters

Hemobilia developed as a complication in nine patients with transhepatic internal biliary drainage catheters. Arteriography revealed pseudoaneurysms of the hepatic artery in five patients and hepatic arterio-portal venous fistulas in three patients. In one patient no arteriographic abnormality was seen. Seven of eight patients were treated successfully with angiographic embolization of the bleeding site. Hemobilia stopped spontaneously in one patient without therapeutic intervention.