[Massive bleeding hemobilia occurred in patient with hepatocellular carcinoma].
Massive bleeding hemobilia occurs rarely in patients with hepatocellular carcinoma (HCC) without any invasive procedure. Upper gastrointestinal bleeding in patient with cirrhosis and abdominal pain with progressive jaundice in patient with HCC were usually thought as variceal bleeding and HCC progression respectively. We experienced recently massive bleeding hemobilia in patient with HCC who was a 73-year old man and showed sudden abdominal pain, jaundice and hematochezia. He had alcoholic cirrhosis and history of variceal bleeding. One year ago, he was diagnosed as HCC and treated with transarterial chemoembolization periodically. Sudden right upper abdominal pain occurred then subsided with onset of hemotochezia. Computed tomography showed bile duct thrombosis spreading in the intrahepatic and extrahepatic ducts, while an ampulla of vater bleeding was observed during duodenoscopy. Hemobilia could be one of the causes of massive bleeding in patients with cirrhosis and HCC especially when they had sudden abdominal pain and abrupt elevation of bilirubin.
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Kyung Eun
KE
Lee
Chang Wook
CW
Kim
Min Ju
MJ
Kim
Jinhee
J
Park
Gu Min
GM
Cho
Jeong Won
JW
Jang
Young Sok
YS
Lee
Chang Don
CD
Lee
D000368:Aged; D017734:Bile Ducts, Extrahepatic; D001653:Bile Ducts, Intrahepatic; D001663:Bilirubin / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D004384:Duodenoscopy; D004621:Embolization, Therapeutic; D006431:Hemobilia / Q000209:etiology*; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D012720:Severity of Illness Index; D013927:Thrombosis / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
D001663:Bilirubin