title: [Acute pancreatitis related to hemobilia complicating hepatocarcinoma].
abstract: Hemobilia is an rare cause of acute pancreatitis. The most frequent causes are iatrogenic trauma (percutaneous liver biopsy) and hepatic artery aneurysm. To our knowledge, this is the second published case of acute pancreatitis related to hemobilia secondary to hepatocarcinoma complicated cirrhosis in a patient treated with anticoagulants for a mechanical valvular aortic prosthesis. The clinical picture included acute epigastric pain, fever and jaundice. Increased amylase and lipase serum activities, and abdominal CT data confirmed the diagnosis of acute pancreatitis. Gallstone induced acute pancreatitis was suspected and thus, a cholecystectomy was performed. No bile duct stones were found but a clot was extracted from the extrahepatic bile duct during surgery. Arterial embolization was then performed and repeated 1 and 3 months later for recurrence. The patient was asymptomatic eight months later. Hepatic arterial embolization is an effective haemostatic treatment for hemobilia, even though, in this case treatment had to be repeated because of an anticoagulant therapy.
authors.affiliation: Service d'Hépato-Gastroentérologie, CHU Trousseau, 37044 Tours Cedex. karsenti@club-internet.fr
authors.forename: David
authors.initials: D
authors.lastname: Karsenti
authors.forename: Juliette
authors.initials: J
authors.lastname: Tchuenbou
authors.forename: Hayete
authors.initials: H
authors.lastname: Djarech
authors.forename: Axel
authors.initials: A
authors.lastname: de Widerspach-Thor
authors.forename: Michel-Ange
authors.initials: MA
authors.lastname: Gomez
authors.forename: Anne
authors.initials: A
authors.lastname: Delhommais
authors.forename: Zine-Abidine
authors.initials: ZA
authors.lastname: Benchellal
authors.forename: Louis
authors.initials: L
authors.lastname: D'alteroche
authors.forename: Etienne
authors.initials: E
authors.lastname: Dorval
mesh_terms: D000208:Acute Disease; D000368:Aged; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000150:complications*; D002758:Cholangiography; D004621:Embolization, Therapeutic; D005500:Follow-Up Studies; D006431:Hemobilia / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011860:Radiography, Abdominal; D012008:Recurrence; D013997:Time Factors; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed