Hemobilia as a rare and serious cause of upper gastrointestinal bleeding
Keywords:
hemobilia, upper gastrointestinal bleeding, arterial aneurysm, cholangiocarcinomaAbstract
Introduction: Hemobilia is, by definition, a cause of upper gastrointestinal bleeding, where there is a communication of the bile duct in any of its segments with blood vessels that flow through the ampulla of Vater. It is rare and it is not suspected in the daily clinical practice of gastroenterologists, surgeons, hepatologists, clinicians and intensivists, hence the diagnostictherapeutic management is difficult and it has high morbidity and mortality.
Objective: To report three cases of patients with a diagnosis of hemobilia.
Case report: We report three cases of hemobilia of high mortality and different etiology. The first case had post-liver transplantation hepatic artery thrombosis, the second had asecondary cholangiocarcinoma of the hepatocystic junction and the third had diagnosis of confirmed right hepatic artery aneurysm partially treated by CT angiography, subsequently operated on and the only survivor.
Conclusions: These three hemobilia cases had different causes, and high mortality due to the intensity of the upper gastrointestinal bleeding and the associated comorbidities, in addition to noting that none of them exhibited the classic triad reported by Quincke.
Keywords: hemobilia; upper gastrointestinal bleeding; arterial aneurysm; cholangiocarcinoma.
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