Haemobilia refers to the 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%)
- vascular malformations (7%)
- e.g. hepatic artery aneurysm or arteriovenous malformation
- can cause massive haemobilia
- malignancy (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.
- high-attenuation clot within the bile ducts
- 1. Hanbidge AE, Buckler PM, O'malley ME et-al. From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant. Radiographics. 24 (4): 1117-35. doi:10.1148/rg.244035149 - Pubmed citation
- 2. Mortimer AM, Wallis A, Planner A. Multiphase multidetector CT in the diagnosis of haemobilia: a potentially catastrophic ruptured hepatic artery aneurysm complicating the treatment of a patient with locally advanced rectal cancer. Br J Radiol. 2011;84 (1001): e95-8. doi:10.1259/bjr/20779582 - Free text at pubmed - Pubmed citation
- 3. Emergency Radiology. Springer. (2007) ISBN:3540689087. Read it at Google Books - Find it at Amazon