title: Hemobilia: another complication associated with anti-thrombotic therapy.
abstract: It is generally accepted that anti-thrombotic therapy increases the risk of gastrointestinal bleeding, and concurrent therapy with a proton-pump inhibitor is the standard treatment for patients receiving aspirin. Therefore, much attention has been paid to the prevention of gastrointestinal bleeding in such patients; however, it should be noted that patients on anti-thrombotic therapy always carry a risk of hemorrhage from any organ, including the gastrointestinal tract. Here, we present a case with formation of a common bile duct stone caused by hemobilia associated with anti-thrombotic therapy. This case suggests that we need to be aware of the possibility of intrabiliary hemorrhage as well as gastrointestinal bleeding in patients receiving anti-thrombotic therapy. Patients with such complications show a variety of symptoms including liver abscess, cholangitis, pancreatitis, and duodenal bleeding.
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Hiramatsu
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. tmhrwtnb@kuhp.kyoto-u.ac.jp.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shiokawa
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kurita
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Matsuura
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Norimitsu
authors.initials: N
authors.lastname: Uza
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Kodama
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Chiba
keywords: Anti-thrombotic therapy; Hemobilia; Liver abscess