Haemobilia

Case contributed by Dr Eric F Greif

Presentation

Abdominal pain status post liver biopsy

Patient Data

Age: 85
Gender: Female
CT

Core needle liver biopsy of liver lesion in a patient with known treated breast cancer.

CT

CT scans performed before and after liver biopsy. There is a change in diffuse internal density of the common bile duct status post biopsy secondary to hemobilia

MRI

There is a change in common bile duct (CBD) internal intensity status post liver biopsy. Pre-biopsy MRI demonstrates normal internal hyperintensity of CBD. Post-biopsy demonstrates heterogenous low T2 and mild T1 in phase hyperintensity. The post contrast T1 fat sat image has internal mild hyperintense debris. Findings are consistent with hemobilia after recent liver biopsy. 

Incidental findings are liver, pancreatic, and renal cysts. Patient has known liver lesions suspicious for metastatic disease, likely from known treated breast cancer, hence  the liver biopsy. The biopsy was inconclusive. 

After biopsy patient had an elevated lipase with imaging findings keeping with mild pancreatitis, secondary to hemobilia. 

 

Case Discussion

Hemobilia is the presence of blood in the biliary tree. 

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Case information

rID: 29261
Case created: 12th May 2014
Last edited: 18th Dec 2015
Inclusion in quiz mode: Included

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