Sonographic findings in traumatic hemobilia: Report of two cases and review of the literature

✍ Scribed by Steven L. Sax; Patricia A. Athey; Neela Lamki; Gilberto A. Cadavid

• Publisher: John Wiley and Sons
• Year: 1988
• Tongue: English
• Weight: 617 KB
• Volume: 16
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870160106

✦ Synopsis

Hemobilia consists of an arteriobili,ary fistula, usually due to central liver rupture with bleeding into the biliary tree. It is due to trauma in over 50% of cases, with an increasing incidence of iatrogenically caused hemobilia. The sonographic findings in two cases of traumatic hemobilia are presented and the literature is reviewed. These findings include clot within the gallbladder and the extrahepatic ducts, liver hematoma, and aneurysm of the hepatic artery. Indexing Words: Ultrasonography Hemobilia Liver hematoma Hepatic artery aneurysm Two cases of traumatic hemobilia are presented to illustrate the difficulty in diagnosing hemobilia, the diverse sonographic findings that may be encountered, and the important role of ultrasound in the diagnosis of hemobilia. The literature concerning sonographic findings in traumatic hemobilia is also reviewed.

CASE REPORTS

Case 1

A 16-year-old male was admitted complaining of intermittent right-upper-quadrant pain, jaundice, and multiple episodes of hematemesis during the preceding month stemming from a fall onto his bicycle handlebars. On physical examination he was cachectic, having lost 20 pounds, jaundiced, and tender over the right upper quadrant. His hematocrit was 18%.

Sonography demonstrated a hypoechoic mass measuring 5 cm x 7 cm in the right lobe of the