Non-operative management of haemobilia.

BACKGROUND

The aim was to evaluate a non-operative approach to the management of haemobilia.

METHODS

This was a retrospective analysis of patients presenting over 10 years with haemobilia. All patients had upper gastrointestinal endoscopy, abdominal ultrasonography and digital subtraction angiography. Superselective coil and/or Gelfoam embolization was done as close as possible to the bleeding site. Completion angiography was performed routinely to confirm adequate embolization.

RESULTS

There were 23 patients with liver trauma and six with inflammatory conditions. All patients required resuscitation with fluids and blood transfusion, and had the haemobilia controlled successfully by angiographic embolization. There was one death from fulminant hepatic sepsis.

CONCLUSION

This series attests to the efficacy of a non-operative approach to haemobilia using radiological diagnosis and intervention.