title: [Hemobilia as the initial manifestation of cholangiocarcinoma in a patient with choledochoduodenostomy].
abstract: Hemobilia occurs when injury or disease causes communication between intrahepatic blood vessels and the intrahepatic or extrahepatic biliary system. The causes of hemobilia include trauma, gallstone disease, vascular malformation, inflammation, and biliary or hepatic tumors. Hemobilia could be diagnosed by endoscopy, hepatic angiography, computed tomography, and ultrasonogram. Patients with hemobilia may present with biliary colic, obstructive jaundice and gastrointestinal bleeding. Extrahepatic cholangiocarcinoma usually presents with obstructive jaundice and is one of the unusual cause of hemobilia. We, herein, report a case of hemobilia caused by cholangiocarcinoma in a 69-year-old woman. She had the past history of lung cancer and choledochoduodenostomy due to gallstone. Esophagogastroduodenoscopy revealed a blood clot protruding from the choledochoduodenostomy site and the ulcerative mass in the common bile duct. Pathologic examination of the ulcerative mass was compatible with those of cholangiocarcinoma.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Dong Yup
authors.initials: DY
authors.lastname: Ryu
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Cheong
authors.forename: Dong Gun
authors.initials: DG
authors.lastname: Lee
authors.forename: Bong Eun
authors.initials: BE
authors.lastname: Lee
authors.forename: Dong Uk
authors.initials: DU
authors.lastname: Kim
authors.forename: Gwang Ha
authors.initials: GH
authors.lastname: Kim
authors.forename: Geun Am
authors.initials: GA
authors.lastname: Song
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000473:pathology; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000473:pathology; D049448:Cholangiopancreatography, Magnetic Resonance; D002768:Choledochostomy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006431:Hemobilia / Q000175:diagnosis*; D006801:Humans