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Rakesh Navuluri
Hemobilia is a rare source of upper gastrointestinal bleeding, though the incidence is increasing along with the rise in minimally invasive biliary interventions. Prompt diagnosis and treatment rests on having appropriate clinical suspicion which should be based on the patient's presenting signs and symptoms, as well as history including recent instrumentation. Endoscopy should be reserved for cases of upper gastrointestinal bleeding with low suspicion for hemobilia. Interventional radiology may be the first-line diagnostic and therapeutic option for patients with a high suspicion of hemobilia...
December 2016: Seminars in Interventional Radiology
Kap Sum Foong, Ashley Lee, Shaismy Kudakachira, Hemchand Ramberan
Biliary angiodysplasia is extremely rare. Our background search revealed only a few case reports in the English literature. We present a case of angiodysplasia of the proximal common bile duct in a patient with subacute upper gastrointestinal bleeding and symptomatic anemia. A standard esophagogastroduodenoscopy with subsequent dedicated duodenoscopy revealed blood-stained bile draining from the major ampulla orifice. A contrast-enhanced magnetic resonance cholangiopancreatography was unrevealing for any pancreaticobiliary pathology...
August 2016: ACG Case Reports Journal
Kristen A Suchniak-Mussari, Beth A Foreman, Amol Sharma, Tanmay Shah, Charles E Dye
No abstract text is available yet for this article.
August 2016: ACG Case Reports Journal
Xiao Zheng, Zhi Yuan Bo, Wei Wan, Ye Chen Wu, Tian Tian Wang, Jun Wu, Dao Jian Gao, Bing Hu
AIM: Endoscopic biliary radiofrequency ablation (RFA) has been increasingly used for unresectable malignant biliary obstruction (MBO). However, its efficacy and safety remain unclear. METHODS: A comprehensive search of Cochrane Library, PubMed and EMBASE was conducted to collect studies to evaluate endoscopic biliary RFA in the management of MBO. Meta-analysis was performed by extracting the data from included studies with regards to the technical effectiveness, overall survival, adverse events and mortality of endoscopic RFA...
October 21, 2016: Journal of Digestive Diseases
Kumble S Madhusudhan, Nihar R Dash, Adil Afsan, Shivanand Gamanagatti, Deep N Srivastava, Arun K Gupta
Biliovenous fistula occurs due to development of a communication between hepatic duct and portal vein branches and is a rare complication of percutaneous transhepatic biliary drainage (PTBD). Most of them are self-limiting and only occasionally they need interventional management. Placement of biliary stent graft is a viable option. We present here a case of a 56-year-old male with carcinoma of gall bladder presenting with hemodynamic shock due to severe hemobilia after PTBD and treated successfully by biliary covered stent placement...
September 2016: Journal of Clinical and Experimental Hepatology
Adriana Cavași, Voicu Mercea, Ofelia Anton, Ion Cosmin Puia
Although transjugular intrahepatic portosystemic shunts are most frequently used for the management of portal hypertension, the surgical approach is preferred for symptomatic portal cavernoma cholangiopathy. We present the case of a 25-year old female patient with a portal cavernoma secondary to catheterization of the umbilical vein at birth. She had had two episodes of esophageal variceal bleeding, successfully treated by endoscopic banding. and an episode of acute cholangitis secondary to portal cavernoma cholangiopathy...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Shogo Kaida, Kyouko Arahata, Asako Itou, Sakiko Takarabe, Kayoko Kimura, Hiroshi Kishikawa, Jiro Nishida, Yoshiki Fujiyama, Yutaka Takigawa, Junichi Matsui
A cystic artery aneurysm is a rare cause of hemobilia. Herein, we report two cases of acute cholecystitis with a ruptured cystic artery pseudoaneurysm. Two patients (a 69-year-old man and an 83-year-old man) were admitted to our hospital because of acute cholecystitis with gallstone impaction in the neck. Percutaneous transhepatic gallbladder drainage (PTGBD) was performed for both patients. After a few days of PTGBD, gallbladder hemorrhage was observed. Abdominal angiography showed cystic artery aneurysm. A transcatheter arterial embolization was therefore performed, followed by an open cholecystectomy...
September 2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Dechao Jiao, Kai Huang, Ming Zhu, Gang Wu, Jianzhuang Ren, Yanli Wang, Xinwei Han
BACKGROUND: Whether unilateral or bilateral drainage should be performed for malignant hilar biliary obstruction remains a matter of debate. Although a Y-stent with a central wide-open mesh facilitates bilateral stent placement, it has its own limitations. AIM: This study aims to evaluate the feasibility and efficacy of a newly designed Y-configured bilateral self-expanding metallic stent (SEMS) for the treatment of hilar biliary obstruction. METHODS: In this retrospective study, 14 consecutive patients with unresectable malignant hilar biliary obstruction (Bismuth type II or higher), who underwent placement of a newly designed Y-configured bilateral SEMS for hilar biliary obstruction from April 2013 to March 2015, were included into this study...
September 1, 2016: Digestive Diseases and Sciences
Mawaddah Alrajraji, Abrar Nawawi, Reda Jamjoom, Yousef Qari, Murad Aljiffry
BACKGROUND: Hepatic artery pseudoaneurysm as a complication of laparoscopic cholecystectomy is considered a rare, potentially life threatening condition. CASE PRESENTATION: We report a case of late onset hemobilia presenting 8 months following elective laparoscopic cholecystectomy with complex biliary and vascular injury. The patient was treated surgically with primary repair of the aneurysm and hepaticojujenostomy. CONCLUSION: A high index of suspicion should be raised when encountering a patient with massive upper GI bleeding and a previous history of hepatobiliary manipulation or surgery regardless of postoperative period...
August 22, 2016: BMC Surgery
Daniel S Zhang, Zeyad Metwalli, Khozema B Hussain
No abstract text is available yet for this article.
July 21, 2016: Clinical Gastroenterology and Hepatology
Tae Young Park, Sung Koo Lee, Kwangwoo Nam, Dongwook Oh, Tae Jun Song, Do Hyun Park, Sang Soo Lee, Dong-Wan Seo, Myung-Hwan Kim
BACKGROUND AND AIM: Spontaneous hemobilia is an uncommon liver transplantation (LT)-related biliary complication. The frequency, etiology, and mechanism of spontaneous hemobilia after LT are not known. This study aimed to assess the outcome of endoscopic management for spontaneous hemobilia after LT, and to investigate its frequency and risk factors. METHODS: The records of patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) to manage hemobilia after LT at the Asan Medical Center, Korea, between January 2006 and April 2014 were retrospectively reviewed...
July 23, 2016: Journal of Gastroenterology and Hepatology
Kiandokht Bashiri, Nader Roushan, Seyyed Mohammadtaghi Hamidian
Ruptured hepatic artery pseudoaneurysm (HAP) generally leads to the hemobilia and can be diagnosed by endoscopy. This condition mostly occurs after an iatrogenic trauma. The management of the HAP is still a big challenge. Due to an increased rate of HAP cases over the last decade, appropriate management is necessary for the optimal outcomes achievement. Here, we report a 59-year-old woman presenting with hematemesis, melena, hematochezia, and epigastric pain. The CT scan of the abdomen showed intrahepatic biliay dilation with hypodense material, probably a clot inside it...
July 2016: Archives of Iranian Medicine
Fabrice Vultaggio, Pierre-Henri Morère, Christophe Constantin, Michel Christodoulou, Didier Roulin
Hemobilia is an uncommon and potential life-threatening condition mainly due to hepato-biliary tree traumatic or iatrogenic injuries. Spontaneously ruptured aneurysm of the hepatic artery is seldom described. We report the case of an 89-year-old woman presenting with abdominal pain, jaundice and gastrointestinal bleeding, whose ultrasound and computed tomography revealed a non-traumatic, spontaneous aneurysm of the right hepatic artery. The oeso-gastro-duodenoscopy and colonoscopy did not reveal any bleeding at the ampulla of Vater, nor anywhere else...
June 27, 2016: World Journal of Gastrointestinal Surgery
Wen Feng, Dong Yue, Lu ZaiMing, Liu ZhaoYu, Zhao XiangXuan, Li Wei, Guo QiYong
PURPOSE: We aimed to evaluate the imaging features of computed tomography (CT) and angiography and the efficacy of transcatheter arterial embolization (TAE) in patients with hemobilia of different iatrogenic causes. METHODS: Thirty patients with hemobilia were divided into two groups according to their iatrogenic causes, i.e., group 1, 11 patients (36.7%) with transhepatic intervention and group 2, 19 patients (63.3%) with surgical procedures in the hilar area. Seventeen patients (56...
July 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
K-S Jeng, C-C Huang, C-K Lin, C-C Lin, C-C Liang, C-S Chung, M-T Weng, K-H Chen
BACKGROUND: Hepatic artery pseudoaneurysm (PA) after liver transplantation (LT) is a rare but potentially fatal complication. Among a series of 50 patients of LT, we experienced 3 such cases. Some authors also have reported cases of PA, either intrahepatic or extrahepatic. The aim of this study was to investigate the important factors that affect the treatment outcome. METHODS: Three patients were presented. To analyze the factors, not only our patients but also the patients with PA reported in the literature (including 10 case series and 23 case reports) were enrolled for analysis...
May 2016: Transplantation Proceedings
Su Young Kim, Jae Hee Cho, Eui Joo Kim, Seung Joon Choi, Yeon Suk Kim
No abstract text is available yet for this article.
June 13, 2016: Gastrointestinal Endoscopy
Jun-Li Tsai, Shang-Feng Tsai
Gallbladder (GB) bleeding is very rare and it is caused by cystic artery aneurysm and rupture, or GB wall rupture. For GB rupture, the typical findings are positive Murphy's sign and jaundice. GB bleeding mostly presented as hemobilia. This is the first case presented with severe GI bleeding because of GB rupture-related GB bleeding. After comparing computed tomography, one gallstone spillage was noticed. In addition to gallstones, uremic coagulopathy also worsens the bleeding condition. This is also the first case that patients with GB spillage-related rupture and bleeding were successfully treated by nonsurgical management...
June 2016: Medicine (Baltimore)
Elsie T Mensah, John Martin, Mark Topazian
PURPOSE OF REVIEW: Intraductal biliary radiofrequency ablation (RFA) is an emerging therapeutic modality that directly targets malignant biliary strictures during endoscopic retrograde cholangiopancreatography. This article reviews the technology, endoscopic technique, and reported outcomes of endoscopic RFA in the management of malignant biliary strictures. RECENT FINDINGS: Biliary RFA is feasible and has a high technical success rate. Infectious complications and major hemobilia are the main adverse events requiring intervention...
May 2016: Current Opinion in Gastroenterology
Tatsuto Shimizu, Haruhiko Shugo, Yuji Hodo, Manabu Yoneshima
A 57-year-old man with a history of excessive drinking presented to our emergency department complaining of chest discomfort. He had been attending a clinic for diabetes mellitus and hypertension, at which he had been informed that he had anemia that was worsening. Computed tomography (CT) of the abdomen revealed hemobilia and chronic pancreatitis. Due to complicated cholangitis, endoscopic nasobiliary drainage was performed, and a contrast-enhanced abdominal CT scan showed a pancreaticoduodenal aneurysm close to the common bile duct...
April 2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Ivica Grgurevic, Milan Kujundzic, Marko Banic, Rajko Kusec, Tomislav Bokun, Mirjana Vukelic-Markovic, Zoran Bogdanovic, Anita Lukic, Emmanouil Tsochatzis, Boris Brkljacic
PURPOSE: To investigate (1) diagnostic performance of transabdominal color doppler ultrasound (US) and endoscopic ultrasound (EUS) for detection and sub-classification of common bile duct varices (CBDV) in patients with portal vein thrombosis (PVT), and (2) clinical significance and natural history of CBDV subtypes. PATIENTS AND METHODS: During a 4-year period, 56 patients with PVT underwent US and EUS for the presence and subtypes of CBDV. Natural history was analyzed for patients who attended control visits...
March 2016: Abdominal Radiology
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