Hemobilia Secondary to Percutaneous Liver Biopsy

Abstract

Hemobilia, or hemorrhage into the biliary tract,¹ is most commonly caused by aneurysms of the hepatic artery² or by blunt abdominal injury leading to liver trauma.³ Other causes of massive hemobilia are unusual but include primary hepatoma,⁴ gallbladder tumors,⁵ foreign bodies, eg, T-tubes,⁶ biliary stones,⁷ acute hemorrhagic cholecystitis,⁸ and liver hemangioma.⁹ Percutaneous needle biopsy of the liver, another form of liver trauma,¹⁰ has been reported only once previously as a cause of hemobilia.¹¹ This report concerns three cases of hemobilia secondary to liver biopsy. As delay in diagnosis or failure to diagnose this condition may adversely affect the patients outcome, we emphasize the clinical features which should lead one to suspect hemobilia and the diagnostic procedures which can be used to localize the source of bleeding prior to operative intervention. Patient Summaries Patient 1. —A 40-year-old man was admitted