Causes of upper gastrointestinal bleeding-related degree of bleeding severity Site Degree of Oesophageal Gastric Duodenal bleeding Major common Oesophageal Gastric varices Benign ulcer varices Portal hypertensive Mallory-Weiss gastropathy tear Benign ulcer Major uncommon Dieulafoy's lesion Haemobilia
Haemosuccus pancreas Aorto-enteric fistula Gastric cancer Usually minor Oesophagitis Gastritis Oesophageal Gastric antral cancer vascular ectasia Table 2.
Changes in the transaminase and phosphatase activity of the blood and the occurrence of haemobilia
following experimental liver trauma in the rabbit.
However this proved to be ineffective (Figure 2), and so the posterior branch of the right hepatic artery was embolised, successfully controlling the haemobilia.
It is important to recognize that iatrogenic causes are the most common cause for haemobilia (52%) (5).
Causes of upper gastrointestinal bleeding-related degree of bleeding severity Site Degree of Oesophageal Gastric Duodenal bleeding Major Oesophageal Gastric Benign ulcer common varices varices Mallory-Weiss Portal tear hypertensive gastropathy Benign ulcer Major Dieulafoy's Haemobilia
uncommon lesion Haemosuccus pancreas Aorto-enteric fistula Gastric cancer Usually Oesophagitis Gastritis minor Oesophageal Gastric antral cancer vascular ectasia
Therefore, the appearance of the classic triad of haemobilia
(abdominal pain, jaundice and upper gastrointestinal bleeding) in the context of a patient with symptoms of cholecystitis should suggest the possibility of an arterial pseudoaneurysm at the hepatic pedicle.
Most cases of CAP are invariably associated with haemoperitoneum or haemobilia
(5), and although colour doppler can be used to diagnose CAP, CT angiogram seems to yield a better diagnostic image.