title: A case report of bloody pancreatitis.
abstract: BACKGROUND
  Haemobilia is an uncommon entity even though its frequency has increased with hepato-biliary instrumentation and procedures. It can be associated with obstructive jaundice and pancreatitis (Green et al., 2001) [1]. Haemobilia following cholecystectomy has frequently been reported in association with hepatic artery pseudo-aneurysm (Curet et al., 1981; Ribeiro et al., 1998) [2,3]. The authors wish to report a case of haemobilia due to a porto-biliary fistula presenting as acute pancreatitis.
  
  
  METHODS
  A 34-year-old female admitted as an urgency with upper abdominal pain for 3 weeks. She had, in the preceding days, been admitted to another hospital with acute pancreatitis. She reported an episode of rectal bleeding during that admission and possessed an abdominal ultrasound scan (USS) and magnetic resonance cholangiopancreatography (MRCP) which suggested the presence of a biliary tract neoplasm. The patient was also found to be jaundiced and the diagnosis of a porto-biliary fistula was made at operation.
  
  
  CONCLUSIONS
  The diagnosis in this case was found to be a portal vein-biliary tract fistula occurring post cholecystectomy. An awareness of the spectrum of complications related to modern surgical techniques may aid timely diagnosis and the achievement of favourable outcomes.
authors.affiliation: Department of Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago; Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago. Electronic address: pran1919@hotmail.com.
authors.forename: Lemuel
authors.initials: L
authors.lastname: Pran
authors.affiliation: Department of Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
authors.forename: Reena
authors.initials: R
authors.lastname: Moonsie
authors.affiliation: Department of Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
authors.forename: James
authors.initials: J
authors.lastname: Byam
authors.affiliation: Department of Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
authors.forename: Shivraj
authors.initials: S
authors.lastname: BahadurSingh
authors.affiliation: Department of Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
authors.forename: Gurubasavaiah
authors.initials: G
authors.lastname: Manjunath
authors.affiliation: Department of Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
authors.forename: Marlon
authors.initials: M
authors.lastname: Seenath
authors.affiliation: Department of Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
authors.forename: Shanta
authors.initials: S
authors.lastname: Baijoo
keywords: Bilio-venous fistula; Haemobilia; Pancreatitis; Porto-biliary fistula