Hemobilia: transcatheter occlusive therapy and long-term follow-up.
Eight patients with life-threatening hemobilia were treated by percutaneous transcatheter occlusive therapy. The bleeding was caused by a traumatic pseudoaneurysm of the hepatic artery in 6 cases (auto accident in 4, surgery in 1, biliary drainage in 1) and a true aneurysm of the hepatic artery in 2 (unknown etiology in 1 and mycotic in 1). Arterial catheterization was used in all cases except for one in which a direct percutaneous puncture was performed. Gelfoam alone was used as embolic material in 3 patients. In 1 patient each, the material used was gelfoam plus coils, coils alone, blood clot, n-butyl-cyanoacrylate and an occluding balloon catheter. In all cases the bleeding stopped and did not recur during the follow-up period which ranged from 9 months to 14 years. This experience indicates that transcatheter occlusive therapy is an effective method for the treatment of severe hemobilia.
Uflacker
R
R
Med-Imagem, Hospital Beneficencia Portuguesa, São Paulo, Brazil.
Mourão
G S
GS
Piske
R L
RL
Souza
V C
VC
Lima
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000150:complications; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable; D006431:Hemobilia / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006499:Hepatic Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013997:Time Factors