Management of bleeding from the bile duct

Abstract

Hemobilia, bleeding originating from the biliary tract or gallbladder, is an uncommonly encountered clinical entity that is most frequently the result of accidental or iatrogenic trauma. Other causes include gallstones, inflammation, vascular disorders, and neoplasms. Manifestations of hemobilia range from minor morbidity to life-threatening hemorrhage, and diagnostic workup by direct or radiographic visualization depends on the presentation. Hemodynamically stable patients can undergo conservative management, and for those patients requiring intervention, angiographic approaches have become the mainstay. Surgical intervention is required if nonoperative measures fail. Clinical suspicion is an important element of diagnosis and subsequent management of hemobilia.