Causa rara de icterícia obstrutiva

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