Hemobilia: Etiology, diagnosis, and treatment  

作　　者：Rani Berry James Han Ani A.Kardashian Nicholas F.LaRusso James H.Tabibian 

机构地区：[1]Department of Internal Medicine,UCLA Ronald Reagan Medical Center,Los Angeles,CA,USA [2]Department of Internal Medicine,University of California Irvine,Irvine,CA,USA [3]UCLA Gastroenterology Fellowship Training Program,Vatche and Tamar Manoukian,Division of Digestive Diseases,Los Angeles,CA,USA [4]Division of Gastroenterology and Hepatology,Mayo Clinic,Rochester,MN,USA [5]Division of Gastroenterology,Department of Medicine,Olive View-UCLA Medical Center,Sylmar,CA,USA

出　　处：《Liver Research》2018年第4期200-208,共9页肝脏研究（英文）

基　　金：This work was supported by the USA National Institutes of Health grant NIDDK DK057993(to NFL).

摘　　要：Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon but important cause of gastrointestinal hemorrhage.Reports of hemobilia date back to the 1600s,but due to its relative rarity and challenges in diagnosis,only in recent decades has hemobilia been more critically studied.The majority of cases of hemobilia are iatrogenic and caused by invasive procedures involving the liver,pancreas,bile ducts and/or the hepatopancreatobiliary vasculature,with trauma and malignancy rep-resenting the two other leading causes.A classic triad of right upper quadrant pain,jaundice,and overt upper gastrointestinal bleeding has been described(i.e.Quincke's triad),but this is present in only 25%e30%of patients with hemobilia.Therefore,prompt diagnosis depends critically on having a high index of suspicion,which may be based on a patient's clinical presentation and having recently undergone(peri-)biliary instrumentation or other predisposing factors.The treatment of hemobilia depends on its severity and suspected source and ranges from supportive care to advanced endoscopic,interventional radiologic,or surgical intervention.Here we provide a clinical overview and update regarding the eti-ology,diagnosis,and treatment of hemobilia geared for specialists and subspecialists alike.

关 键 词：HEMOBILIA Upper gastrointestinal hemmorhage ETIOLOGY DIAGNOSIS IMAGING Hepatopancreatobiliary interventions 

分 类 号：R57[医药卫生—消化系统]