Hemobilia

Changed by Hamish Smith, 9 May 2018

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Haemobilia refers to the ~~presence of blood~~ presence of blood in the biliary tree.

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

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 haemobilia
malignancy~~: most commonly~~ (e.g. hepatocellular carcinoma - most common, gallbladder metastases)
abscess formation
gastrointestinal bleed due to gallstones

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

-<p><strong>Haemobilia </strong>refers to the presence of blood in the <a href="/articles/biliary-tree-anatomy">biliary tree</a>.</p><h4>Clinical presentation</h4><p>The classical clinical triad, only seen in ~50% of cases, consists of:</p><ol>
+<p><strong>Haemobilia </strong>refers to the presence of blood in the <a href="/articles/biliary-tree-anatomy">biliary tree</a>.</p><h4>Clinical presentation</h4><p>The classical clinical triad, only seen in ~50% of cases, consists of:</p><ol>
~~-<li>malignancy: most commonly <a href="/articles/hepatocellular-carcinoma">hepatocellular carcinoma</a>~~
~~-</li>~~
+<li>malignancy (e.g. <a href="/articles/hepatocellular-carcinoma">hepatocellular carcinoma</a> - most common, <a title="Gallbladder metastases" href="/articles/gallbladder-metastases">gallbladder metastases</a>)</li>
~~-<li>gastrointestinal bleed due to <a href="/articles/cholelithiasis">gallstones</a>~~
+<li>gastrointestinal bleed due to <a href="/articles/gallstones-1">gallstones</a>