%0 Journal Article
%T Hemobilia caused by a ruptured hepatic cyst: a case report
%A Viplove Senadhi
%A Deepika Arora
%A Manish Arora
%A Sudhir Dutta
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-26
%X A 91-year-old African-American woman was referred to our out-patient gastroenterology clinic for evaluation of mild epigastric pain and intermittent melena. An abdominal computed tomography scan was remarkable for multiple hepatic cysts. Esophagogastroduodenoscopy revealed multiple blood clots at the ampulla of Vater. Endoscopic retrograde cholangiopancreatography showed a single 18 mm-sized filling defect in the common hepatic duct wall at the junction of the right and left hepatic duct, adjacent to one of the hepatic cysts. The ruptured hepatic cyst communicated to the bile ducts and was the cause of hemobilia with an atypical clinical presentation.Hemobilia is an infrequent cause of upper gastrointestinal bleeding and rarely occurs due to hepatic cyst rupture. To the best of our knowledge, this is only the second case report in the literature that describes hemobilia due to hepatic cyst rupture. However, it is the first case in the literature of hemobilia due to hepatic cyst rupture in the absence of iatrogenic or spontaneous trauma, and in the absence of a spontaneous or pathological coagulopathy.Hemobilia is a rare cause of upper gastrointestinal bleeding. The widespread use of imaging modalities such as magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS), and high-resolution computed tomography (CT) have facilitated the diagnosis of hepatic disorders and increased the indication for invasive hepatobiliary procedures. These procedures in turn increase the incidence of hemobilia. A review of hemobilia cases by Sandblom indicated that trauma was the cause of hemobilia in half the cases, with one-third of these hemobilia cases being iatrogenic, and needle biopsy of the liver representing the most common cause [1,2].Other factors commonly associated with hemobilia include percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangiopancreatography (ERCP), sphincterotomy, instrumental exploration of bile ducts, and bili
%U http://www.jmedicalcasereports.com/content/5/1/26