Hemobilia: Diagnosis and Management

Hemobilia is an uncommon cause of gastrointestinal hemorrhage and difficult to diagnosis. Clinical presentationsare upper gastrointestinal hemorrhage, abdominal pain and obstructive jaundice. There are various mechanisms ofhemobilia such as bleeding tumor of bile duct, ductal tear, a communication or fistula between the biliary tract andvascular system resulting from iatrogenic, trauma, tumor, gallstone, inflammation and vascular disorder. Urgent investigation should be done by endoscopy, computerized angiography and angiography for definite diagnosis and plan of treatment. The principle of therapy are resuscitation, control hemorrhage and restoration bile flow from obstruction. Multimodality approach is the mainstay of treatment including medical therapy, endoscopy, intervention radiology and surgery.