title: Non-operative management of endoscopic iatrogenic haemobilia: case report and review of literature.
abstract: Haemobilia denotes an abnormal communication between a vessel of the splanchnic circulation and the biliary system. Patients typically presents with the triad of abdominal pain, upper gastrointestinal haemorrhage, and jaundice. Common causes for haemobilia are iatrogenic causes secondary to hepatobiliary system instrumentation and trauma. Management of patients with haemodynamic significant haemobilia is aimed at stopping bleeding, maintaining continuous flow of biliary system, and cure of the underlying aetiology. Iatrogenic haemobilia after ERCP polyethylene biliary endoprosthesis placement is extremely uncommon. Herein we present a case of iatrogenic haemobilia triggered by biliary endoprosthesis placement and was successfully managed by non-operative treatment. The management algorithm for a rational approach to haemobilia is discussed.
authors.affiliation: Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT. wtsiu@netvigator.com
authors.forename: W T
authors.initials: WT
authors.lastname: Siu
authors.forename: C H
authors.initials: CH
authors.lastname: Chau
authors.forename: B
authors.initials: B
authors.lastname: Ka Bo Law
authors.forename: K K
authors.initials: KK
authors.lastname: Yau
authors.forename: Y W
authors.initials: YW
authors.lastname: Luk
authors.forename: M
authors.initials: M
authors.lastname: KaWah Li
mesh_terms: D000792:Angiography / Q000379:methods; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D042883:Choledocholithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D006431:Hemobilia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects*; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome