58-year-old Patient Experiences Severe Hemobilia Post Liver Biopsy

• Background:

  • Patient details: 58 years old, NAFLD, diabetes mellitus, hypertension

  • Procedure: Underwent liver biopsy

• Symptoms 24hrs post-biopsy:

  • Acute abdominal pain

  • Jaundice & chills

  • Melenic stools

• Emergency Room Findings:

  • Low blood pressure & rapid heart rate

  • Icteric sclerae

  • CT: Dilated bile duct with potential sludge/stones

  • ERCP: Multiple irregular defects in biliary tree

  • Treatment: Biliary sphincterotomy, blood clot extraction, plastic stent insertion (removed after 4 weeks)

• About Hemobilia:

  • Causes: Primary cancer, trauma, gallstones, liver biopsy, etc.

  • Indicators (Quinke's triad): Epigastric pain, jaundice, gastrointestinal bleeding (not always all three)

  • Diagnosis: Endoscopy, CT imaging, ERCP with cholangiography

  • Treatment: Biliary tree decompression, drainage, blood transfusion if needed, address underlying cause

Conclusion: Hemobilia, though rare, can be a severe post-procedure complication, requiring prompt diagnosis and effective treatment.