Hemobilia as the initial manifestation of cholangiocarcinoma in a hemophilia B patient  

作　　者：Anastassios C Manolakis Andreas N Kapsoritakis Antonis D Tsikouras Fotis D Tsiopoulos Athanassios K Psychos Spyros P Potamianos 

机构地区：[1]Department of Gastroenterology,University of Thessaly,School of Medicine, Larissa 41447,Greece

出　　处：《World Journal of Gastroenterology》2008年第26期4241-4244,共4页世界胃肠病学杂志（英文版）

摘　　要：Hemobilia is a rare manifestation of hemophilia and is usually iatrogenic following liver biopsy. There are only few reports of spontaneous hemobilia in hemophilia patients. Cholangiocarcinoma is a well-established cause of hemobilia. We describe a case of a 70-year-old male, with known haemophilia B and a past history of papillotomy, who presented with classical symptoms of hemobilia. The initial diagnostic work-up failed to demonstrate a potential cause of bleeding other than the coagulopathy. Three months later, he was readmitted to our hospital with a second episode of hemobilia. During the second work-up, a cholangiocarcinoma was diagnosed both by imaging studies and by a significant elevation of cancer antigen 19-9. Although hemobilia could be attributed to hemophilia, especially in a patient with previous papillotomy, an underlying malignancy of the biliary tree should be suspected.Hemobilia is a rare manifestation of hemophilia and is usually iatrogenic following liver biopsy. There are only few reports of spontaneous hemobilia in hemophilia patients. Cholangiocarcinoma is a well- established cause of hemobilia. We describe a case of a 70-year-old male, with known haemophilia B and a past history of papillotomy, who presented with classical symptoms of hemobilia. The initial diagnostic work-up failed to demonstrate a potential cause of bleeding other than the coagulopathy. Three months later, he was readmitted to our hospital with a second episode of hemobilia. During the second work-up, a cholangiocarcinoma was diagnosed both by imaging studies and by a significant elevation of cancer antigen 19-9. Although hemobilia could be attributed to hemophilia, especially in a patient with previous papillotomy, an underlying malignancy of the biliary tree should be suspected.

关 键 词：HEMOBILIA HEMOPHILIA CHOLANGIOCARCINOMA Cancer antigen 19-9 Cholangiopan-creatography 

分 类 号：R55[医药卫生—血液循环系统疾病] R735.8[医药卫生—内科学]