Our minor complications included access site pain in 17 cases (12%), transient hemobilia
lasting less than 24 hours in 15 cases (10%), drain blockage/dislodgement in 6 cases (4%) and subcapsular collection in 3 cases (2%).
Common Causes Rare Causes Under 40 years old Over 40 years old Henoch--Schoenlein purpura Inflammatory bowel Angioectasia Amyloidosis disease Dieulafoy lesions Dieulafoy lesions Osler--Weber--Rendu syndrome Neoplasia Neoplasia Hemobilia
Meckel diverticulum NSAID ulcers Aortoenteric fistula Polyposis syndromes Small bowel varices and (e.g.
An 81-year-old male with tarry stool for a day reported to have direct bleeding from the ampulla of Vater had endoscopic confirmation of hemobilia
. For the next 24 hours, significant Murphy's sign was observed.
due to intracholecystic papillary neoplasm.
Duodenal ulcer and hemobilia
were detected in two and one patient, respectively.
, in the most elemental sense, refers to the admixture of blood in bile or to blood in the biliary tract.
The dangerous emphysematous form can also present with nonspecific chronic or subacute upper abdominal pain, jaundice due to bile duct obstruction or the hemolytic effect of clostridia species [13, 14], the unexpected imaging finding of air in the gallbladder wall, a polypoid lesion or biliary fistula on imaging , or GI bleeding from an ischemic or necrotic gallbladder source, termed "hemobilia
" [16, 17].
is a rare cause of gastrointestinal bleeding; however, a higher number of invasive hepatobiliary interventions and advancements in imaging technologies have increased the number of reported cases.
A review article by Ikeuchi and Itoi involving 38 studies reported that the most common complication of EUS-CDS procedures was peritonitis, and other complications included pneumoperitonitis, bleeding, bile leakage, perforation, abdominal pain, biloma, cholangitis, pancreatitis, hemobilia
, and stent misplacement.
Incidences of hemobilia
and biliary fistula have also been reported .
HAP may present with nonspecific symptoms including hemobilia
, falling hemoglobin levels gastrointestinal bleeding, or hemoperitoneum .
Biliary venous fistulas may result in recurrent bacteremia, jaundice, hemobilia
, bilihemia, anemia, fever, liver failure, and death.