Hemobilia
Hemobilia refers to blood draining into the duodenum via the common bile duct. The source of bleeding can be anywhere along the biliary tract, the liver, or the ampullary region. The most common cause of hemobilia is trauma. Other causes include; papillary thyroid carcinoma, surgery (e.g. common bile duct exploration, cholecystectomy), tumors, and infection. Patients usually present with melena, hematemesis, jaundice, and right upper quadrant pain. Diagnosis is made by arteriogram and upper GI endoscopy, which shows blood coming out of the ampulla of Vater. Treatment includes resuscitation of the patient. If the bleeding is severe, surgery is necessary. Surgical options include; ligation of hepatic arteries or arteriogram with embolization of vessel.
