Non-operative management of haemobilia.
BACKGROUND
The aim was to evaluate a non-operative approach to the management of haemobilia.


METHODS
This was a retrospective analysis of patients presenting over 10 years with haemobilia. All patients had upper gastrointestinal endoscopy, abdominal ultrasonography and digital subtraction angiography. Superselective coil and/or Gelfoam embolization was done as close as possible to the bleeding site. Completion angiography was performed routinely to confirm adequate embolization.


RESULTS
There were 23 patients with liver trauma and six with inflammatory conditions. All patients required resuscitation with fluids and blood transfusion, and had the haemobilia controlled successfully by angiographic embolization. There was one death from fulminant hepatic sepsis.


CONCLUSIONS
This series attests to the efficacy of a non-operative approach to haemobilia using radiological diagnosis and intervention.
Moodley
J
J
Department of General Surgery, University of Natal, Durban, South Africa. moodleyj6@nu.ac.za
Singh
B
B
Lalloo
S
S
Pershad
S
S
Robbs
J V
JV
D000293:Adolescent; D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis; D003937:Diagnosis, Differential; D004378:Duodenal Diseases / Q000175:diagnosis; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis; D005782:Gels / Q000627:therapeutic use*; D006431:Hemobilia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D012189:Retrospective Studies
D005782:Gels