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IR Management of Hemobilia

  • Ujjwal Gorsi
Chapter
  • 37 Downloads

Abstract

Hemobilia is an uncommon, but important, cause of gastrointestinal bleeding. Invasive procedures involving the hepatopancreatobiliary system are the main culprit for this rare cause of hemorrhage. Prompt detection and urgent endovascular interventions are usually required to overcome this life-threatening situation. In this chapter, etiology, mechanism, clinical features, diagnosis, and approach for management of hemobilia will be briefly described. The endovascular and percutaneous techniques, hardware requirements and selection of embolization agents in various situations would be dealt with in greater detail.

Keywords

Hemobilia Iatrogenic Pseudoaneurysm Endovascular Embolization 

References

  1. 1.
    Glisson F. Anatomia Hepatis. London: O. Pullein; 1654.Google Scholar
  2. 2.
    Sandblom P. Hemorrhage into the biliary tract following trauma; traumatic hemobilia. Surgery. 1948;24(3):571–86.PubMedGoogle Scholar
  3. 3.
    Quinke H. Ein Fall von Aneurysma der Leberarterie. Klin Wochenschr. 1871;88:773–86.Google Scholar
  4. 4.
    Murugesan SD, Sathyanesan J, Lakshmanan A, et al. Massive hemobilia: a diagnostic and therapeutic challenge. World J Surg. 2014;38(7):1755–62.CrossRefGoogle Scholar
  5. 5.
    Green MH, Duell RM, Johnson CD, et al. Haemobilia. Br J Surg. 2001;88(6):773–86.CrossRefGoogle Scholar
  6. 6.
    Berry R, Han J, Kardashian HA, et al. Hemobilia: etiology, diagnosis, and treatment. Liver Res. 2018 Dec;2(4):200–8.CrossRefGoogle Scholar
  7. 7.
    Zhou H-B. Hemobilia and other complications caused by percutaneous ultrasound-guided liver biopsy. World J Gastroenterol. 2014;20(13):3712–5.CrossRefGoogle Scholar
  8. 8.
    Rivera-Sanfeliz GM, Assar O, LaBerge JM, et al. Incidence of important hemobilia following transhepatic biliary drainage: left- sided versus right-sided approaches. Cardiovasc Intervent Radiol. 2004;27(2):137–9.CrossRefGoogle Scholar
  9. 9.
    Navuluri R. Hemobilia. Semin Intervent Radiol. 2016;33(4):324–31.CrossRefGoogle Scholar
  10. 10.
    Chin MW, Enns R. Hemobilia. Curr Gastroenterol Rep. 2010;12(2):121–9.CrossRefGoogle Scholar
  11. 11.
    Vachhani PG, Copelan A, Remer EM, Kapoor B. Iatrogenic hepa- topancreaticobiliary injuries: a review. Semin Intervent Radiol. 2015;32(2):182–94.CrossRefGoogle Scholar
  12. 12.
    Tessier DJ, Fowl RJ, Stone WM, et al. Iatrogenic hepatic artery pseudoaneurysms: an uncommon complication after hepatic, biliary, and pancreatic procedures. Ann Vasc Surg. 2003;17(6):663–9.CrossRefGoogle Scholar
  13. 13.
    Goffette PP, Laterre PF. Traumatic injuries: imaging and interven- tion in post-traumatic complications (delayed intervention). Eur Radiol. 2002;12(5):994–1021.CrossRefGoogle Scholar
  14. 14.
    Mutignani M, Shah SK, Bruni A, Perri V, Costamagna G. Endoscopic treatment of extrahepatic bile duct strictures in patients with portal biliopathy carries a high risk of haemobilia: report of 3 cases. Dig Liver Dis. 2002;34(8):587–91.CrossRefGoogle Scholar
  15. 15.
    Bismuth H. Hemobilia. N Engl J Med. 1973;288(12):617–9.CrossRefGoogle Scholar
  16. 16.
    Kandarpa K, Machan L, Durham JD. Handbook of interventional radiologic procedures. New York: Wolters Kluwer; 2016.Google Scholar
  17. 17.
    Srivastava DN, Sharma S, Pal S, et al. Transcatheter arterial embolization in the management of hemobilia. Abdom Imaging. 2006;31(4):439–48.CrossRefGoogle Scholar
  18. 18.
    Cagli B, Tuncel SA, Sengul E, et al. Hemobilia and occult cystic artery stump bleeding after a laparoscopic cholecystectomy: endovascular treatment with N-butyl cyanoacrylate. Prague Med Rep. 2011;112(2):132–6.PubMedGoogle Scholar
  19. 19.
    Krokidis ME, Hatzidakis AA. Acute hemobilia after bilioplasty due to hepatic artery pseudoaneurysm: treatment with an ePTFE-covered stent. Cardiovasc Intervent Radiol. 2009;32(3):605–7.CrossRefGoogle Scholar
  20. 20.
    Ruffino M, Rabbia C, Italian Cardiatis Registry Investiagtors Group. Endovascular treatment of visceral artery aneurysms with Cardiatis multilayer flow modulator: preliminary results at six-month follow-up. J Cardiovasc Surg. 2011;52:311–21.Google Scholar
  21. 21.
    Anton S, Stahlberg E, Horn M, Wiedner M, Kleemann M, Barkhausen J, et al. Initial experience with the E-ventus(R) stent-graft for endovascular treatment of visceral artery aneurysms. J Cardiovasc Surg. 2018;59(2):225–31.Google Scholar
  22. 22.
    Gorsi U, Chaluvashetty S, Kalra N, et al. Percutaneous glue embolization as a primary treatment for visceral pseudoa- neurysms. Minim Invasive Ther Allied Technol. 2019;23:1.Google Scholar
  23. 23.
    Prasad TV, Gupta AK, Garg P, Pal S, Gamanagatti S. Minimally invasive image-guided interventional management of Haemobilia. Trop Gastroenterol. 2015;36(3):179–84.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2021

Authors and Affiliations

  • Ujjwal Gorsi
    • 1
  1. 1.Department of Radio DiagnosisPGIMERChandigarhIndia

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