Hemobilia is hemorrhage into the biliary tract that may follow trauma, including surgical and needle liver biopsy, aneurysms of the hepatic artery or one of its branches, extra-or intra-hepatic tumors of the biliary tract, gallstone diseases,
inflammation of the liver, especially helminthic or pyogenic, rarely varicose veins related to portal hypertension and sometimes is associated with primary liver cancer.
A 55 year-old man was admitted to Maryknoll hospital November 8th, 1991 due to intermittent right upper quadrant pain for 4 days before admission. Physical examination revealed dry mouth, severe tenderness on RUQ. But there were no
lymphadenopathy
no
hepatosplenomegaly and no palpable mass on abdomen. Upon admission, serum transaminase and bilirubin were elevated. All viral markers including HBsAg, anti-HCV, anti-HAV were negative and cs pw skin test were also non-specific findings. Stool
occult
blood was positive and serum Ca19-9 was elevated.
Through ERCP, impacted CBD stone with hemobilia was removed. And repeated ERCP was done. The hemobilia and stone were not seen and normal CBD under 2nd ERCP. And serum transaminase, bilirubin, Hb/Hct, Ca19-9 were within normal limit.
We report a case of hemobilia with obstructive jaundice.
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