Hemobilia
Reichow, W.; Becker, H.D.; Fölsch, U.R.
Der Chirurg; Zeitschrift für Alle Gebiete der Operativen Medizen 54(12): 811-814
1983
ISSN/ISBN: 0009-4722 PMID: 6661967 Document Number: 197627
Hemobilia is caused by a pathological communication between the biliary tract and the intra- and extrahepatic blood vessels; multifarious pathogenetical mechanisms of this syndrome have to be considered. The trias of colicky upper abdominal pain, jaundice and haemorrhage in the upper gastrointestinal tract determinates the clinical picture. To ensure the diagnosis and to localize the source of bleeding sonography, endoscopic retrograde cholangiography (ERC) and coeliacography are indispensable. Besides the transvasal selective embolization ligature of the hepatic artery resection of the affected part of the liver just as reconstructive vascular operations serve as therapeutical tools in this disease. A patient complaining of intrahepatic hemobilia is described who was successfully treated by highly selective ligature of the respective vessel after intraoperative angiography through the stump of the cystic artery. Using this procedure the resection of the affected part of the liver could be avoided.