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Haemobilia

Dr Ayush Goel and Radswiki et al.

Haemobilia merely refers to the presence of blood in the biliary tract.

Classical clinical triad, only seen in approximately 50% of cases, consists of:

  1. melena
  2. jaundice
  3. abdominal pain

Pathology

Causes

Two-thirds of cases of hemobilia are iatrogenic (e.g. PTC) while trauma accounts for 5%. Haemobilia may manifest many weeks after the initial injury.

  • iatrogenic (surgical or percutaneous procedures)
  • trauma
  • aneurysm of hepatic artery (can cause massive haemobilia)
  • tumors (most commonly HCC)
  • GI bleed due to gall stones

Radiographic features

Ultrasound

Ultrasound is often the first investigation and reveals echogenic material in bile ducts and dilated gallbladder.

CT

High-attenuation clot within the bile ducts.

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