%0 Journal Article %T Causa rara de icter¨ªcia obstrutiva Rare cause of obstructive jaundice %A Liliana Santos %A Jo£¿o Coimbra %A Isabel Sousa %A Gon£¿alo Ramos %J Jornal Portugu¨ºs de Gastrenterologia %D 2012 %I Sociedade Portuguesa de Gastrenterologia %X A hemobilia ¨¦ uma afec o rara, que < 10% dos casos est¨¢ associada a neoplasias hep¨¢ticas ou intra biliares. Apresentamos um doente com cirrose hep¨¢tica alco¨®lica, internado por icter¨ªcia e col¨²ria. A colangiopancreatografi a retr¨®grada endosc¨®pica (CPRE) n o revelou dilata o ou altera es endoluminais da via biliar principal, tendo se extra¨ªdo microc¨¢lculos ap¨®s explora o com bal o de Forgaty e cesto de Dormia. Vinte e quatro horas ap¨®s o procedimento, verifi cou-se agravamento da icter¨ªcia, tendo repetido CPRE que mostrou a presen a de co¨¢gulos na via biliar principal. A investiga o cl¨ªnica subsequente revelou uma les o nodular hep¨¢tica com 6 cm de diametro e extens o para a ¨¢rvore biliar peri hilar. O doente faleceu ao 33o dia de internamento por choque s¨¦ptico secund¨¢rio a infec o respirat¨®ria Hemobilia is a rare affection, which in less than 10% of the cases is associated with hepatic or intrabiliary neoplasm. We present a patient, with alcoholic hepatic cirrhosis that presented with jaundice and coluria. Endoscopic retrograde cholangiopancreatography [ERCP] was negative for dilation or endoluminal lesions of the common bile duct; Forgaty balloon and Dormia basket exploration revealed biliary microlithiasis. Due to clinical deterioration, with increasing jaundice 24 hours, another ERCP was performed, that disclosed the presence of a blood clot in the common biliary duct. The following clinical investigation showed a 6 cm hepatic nodule that extended to the peri hilar biliary tree. The patient died 33 days after the admission, due to septic shock secondary to respiratory tract infection %K Hemoptises %K Etiologia %K Diagn¨®stico %K Tratamento %K Hemoptysis %K Etiology %K Diagnosis %K Treatment %U http://www.scielo.oces.mctes.pt/scielo.php?script=sci_arttext&pid=S0872-81782012000200008