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

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

  • 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.