An unusual case of haemobilia.
Arterio-biliary fistula is an uncommon cause of haemobilia. We describe a case of right hepatic artery pseudo-aneurysm causing arterio-biliary fistula and presenting as severe melaena and cholangitis. Gastroduodenoscopy failed to establish the exact source of bleeding and hepatic artery angiography and selective embolization of the pseudo-aneurysm successfully controlled the bleeding. Pseudo-aneurysm of the hepatic artery is mostly iatrogenic due to biliary intervention, as demonstrated in this case. Difficulty in diagnosis and management is discussed together with a review of the literature.
Rai
Rakesh
R
HPB Surgery and Liver Transplant Unit, and Department of Interventional Radiology, Freeman Hospital, Newcastle, UK. Rai2000@hotmail.com
Rose
John
J
Manas
Derek
D
D017541:Aneurysm, False / Q000150:complications*; D001658:Biliary Fistula / Q000150:complications; D016063:Blood Loss, Surgical; D003137:Common Bile Duct Diseases / Q000150:complications; D005260:Female; D006431:Hemobilia / Q000209:etiology*; D006499:Hepatic Artery; D006801:Humans; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects; D016157:Vascular Fistula / Q000150:complications