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Case ReportOpen Access
Hemobilia : Four Case Reports and Review of the Literature
ThongNgam D 
,
Shusang V ,
Wongkusoltham P ,
Brown L ,
Kullavanijaya P
,
Shusang V ,
Wongkusoltham P ,
Brown L ,
Kullavanijaya P In this report, we present four cases of hemobilia. Hemobilia occurs when conditions
produce an abnormal communication between blood vessels and bile ducts. Although iatrogenic
procedures as causes of hemobilia have been reported with increasing frequency, non-iatrogenic
etiologies are still quite rare. We, therefore, report 4 cases of hemobilia secondary to different
etiologies found in our institution from 1996 to 1998, that are non-iatrogenic. The first patient
was a case of congenital aneurysm, the second pseudoaneurysm from trauma, the third cholangio-
carcinoma and the fourth hepatocellular carcinoma. The classical triad consists of melena, jaundice
and abdominal pain. Direct observation of blood flowing from the Ampulla of Vater by endos-
copy was the initial diagnostic procedure in all four cases. Diagnosis was confirmed by ultra-
sonography, computerized tomography, angiography or surgery. Transcatheter selective emboli-
zation as a noninvasive treatment for hepatic aneurysm
I
pseudoaneurysm is emphasized.
Key word
: Hemobilia
produce an abnormal communication between blood vessels and bile ducts. Although iatrogenic
procedures as causes of hemobilia have been reported with increasing frequency, non-iatrogenic
etiologies are still quite rare. We, therefore, report 4 cases of hemobilia secondary to different
etiologies found in our institution from 1996 to 1998, that are non-iatrogenic. The first patient
was a case of congenital aneurysm, the second pseudoaneurysm from trauma, the third cholangio-
carcinoma and the fourth hepatocellular carcinoma. The classical triad consists of melena, jaundice
and abdominal pain. Direct observation of blood flowing from the Ampulla of Vater by endos-
copy was the initial diagnostic procedure in all four cases. Diagnosis was confirmed by ultra-
sonography, computerized tomography, angiography or surgery. Transcatheter selective emboli-
zation as a noninvasive treatment for hepatic aneurysm
I
pseudoaneurysm is emphasized.
Key word
: Hemobilia
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