title: Cholangiocarcinoma presenting as hemobilia and recurrent iron-deficiency anemia: a case report.
abstract: BACKGROUND
  Iron-deficiency anemia is a relatively common presenting feature of several gastrointestinal malignancies. However, cholangiocarcinoma has rarely been reported as an underlying cause. The association of cholangiocarcinoma with the rare clinical finding of hemobilia is also highly unusual. To our knowledge, this is the first case report of cholangiocarcinoma presenting with acute hemobilia and chronic iron-deficiency anemia.
  
  
  METHODS
  We report the case of a Caucasian, 84-year-old woman presenting with recurrent, severe iron-deficiency anemia who was eventually diagnosed with intra-hepatic cholangiocarcinoma, following an acute episode of hemobilia. A right hepatectomy was subsequently performed with curative intent, and our patient has now fully recovered.
  
  
  CONCLUSIONS
  This is a rare example of hemobilia and chronic iron-deficiency anemia in association with cholangiocarcinoma. We suggest that a diagnosis of cholangiocarcinoma should be considered in patients who present with iron-deficiency anemia of unknown cause, particularly in the presence of abnormal liver function.
authors.affiliation: Trent Cardiac Centre, Nottingham University Hospitals NHS Trust, NG5 1PB, UK. Saif83@hotmail.co.uk.
authors.forename: Saif S
authors.initials: SS
authors.lastname: Ahmad
authors.forename: Faisal Tm
authors.initials: FT
authors.lastname: Basheer
authors.forename: Saad F
authors.initials: SF
authors.lastname: Idris
authors.forename: Radhakrishnan
authors.initials: R
authors.lastname: Hariraj
authors.forename: Rajarathnam
authors.initials: R
authors.lastname: Mathialagan
authors.forename: Andrew
authors.initials: A
authors.lastname: Douds
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