Clinical features and endoscopic management of non-iatrogenic hemobilia / 中华消化内镜杂志

ABSTRACT

Objective To investigate the role of endoscopic retrograde cholangiopancreatography (ERCP) management in the diagnosis and treatment and illustrate clinical features of non-iatrogenic hemobi lia.Methods A total of 35 patients diagnosed as hemobilia via endoscope from August 2009 to September 2012 were reviewed retrospectively.Patients with iatrogenic causes of hemobilia were excluded in this study.Results The clinical features of hemobilia mainly included jaundice (77.1％),abdominal pain (62.9％),hematemesis (5.7％),melena (2.9％) and hematochezia (2.9％).Quincke triad was found in 4 patients with hemobilia.Hemobilia were caused by hepatobiliary malignancies in 29 patients and benign biliary tract diseases in the other six.Biliary obstruction caused by hemobilia was successfully ameliorated by ERCP in 34 patients.Postoperative pancreatitis ocurred in 1 patient.Conclusion The common noniatrogenic causes of hemobilia were hepatobiliary and pancreatic malignancies.ERCP is recommended as the initial management to confirm the hemobilia and solve biliary obstruction.