title: [A case of hemobilia developing after radiofrequency ablation (RFA) for hepatocellular carcinoma].
abstract: We report a case of hemobilia developing after RFA for hepatocellular carcinoma. A 75-year-old woman with hepatitis C was diagnosed as hepatocellular carcinoma (d=15 mm) located in subsegment 7. Laboratory data on admission are AFP 37.3 ng/mL, PIVKA-II 20 mAU/mL, GOT/GPT 84/52 IU/L, T-Bil 1.1 mg/dL, Alb 3.8 g/dL, Plt 8.9x104/microL, and PT 11.8 seconds (INR 1.28) "Child classification A". Under general anesthesia, percutaneous RFA (Cool-tip radionics 10 minutes) was performed. Tumor appeared to be well treated, but on day 5 after the procedure, the patient had sudden upper abdominal pain, followed by the elevation of total bilirubin conc. (3.3 mg/dL) and decrease of Hb. Abdominal ultrasonography showed a debris-like shadow in the gall bladder. Hemobilia was confirmed because endoscopic examination revealed blood contaminated bile from the papilla Vater. Since spontaneous thrombolysis is known to occur in the bile, the patient was only followed by MRI. Symptoms were subsided in a week without any treatment. Obstructive jaundice due to hemobilia is a rare complication of RFA, and may be followed without any treatment.
authors.affiliation: Department of Surgery, Nishinomiya Municipal Central Hospital.
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamashita
authors.forename: Masato
authors.initials: M
authors.lastname: Sakon
authors.forename: Itsuro
authors.initials: I
authors.lastname: Souma
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Hayashi
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Nakano
authors.forename: Naozumi
authors.initials: N
authors.lastname: Higaki
authors.forename: Masakazu
authors.initials: M
authors.lastname: Murakami
authors.forename: Hirohito
authors.initials: H
authors.lastname: Hayashida
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kan
authors.forename: Takao
authors.initials: T
authors.lastname: Ichihara
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006431:Hemobilia / Q000209:etiology*; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D008113:Liver Neoplasms / Q000601:surgery*