Abakumov M M, Vladimirova E S, Tsurova D Kh, Chernaia N R, Donova L V
Khirurgiia (Mosk). 2006(8):10-6.
Authors describe experience of diagnosis and treatment of hemobilia at 10 of 743 patients with trauma of liver. At 7 patients hemobilia was due to closed trauma, and at 3--due to injuries. For diagnosis of hemobilia the USE, Doppler examination of hepatic vessels, esophagogastroduodenoscopy, selective angiography of liver were used. Selective embolization was effective at 7 of 8 patients. Hemobilia has been cured conservatively at 2 patients. Two patients died. It is concluded that complex examination including dopplerography of hepatic liver, esophagogastroduodenoscopy, selective angiography is necessary for diagnosis of traumatic hemobilia. Traumatic hemobilia must be suspected at patients with symptoms of gastrointestinal bleeding in postoperative (posttraumatic) period, and diagnosis of other sources of bleeding does not exclude hemobilia. Selective angiography and embolization of afferent arterial branch is the most effective and safe method of traumatic hemobilia treatment.
作者描述了743例肝外伤患者中10例血胆症的诊断和治疗经验。7例血胆症由闭合性创伤引起，3例由开放性损伤引起。诊断血胆症采用了超声检查（USE）、肝血管多普勒检查、食管胃十二指肠镜检查、肝脏选择性血管造影。8例患者中有7例选择性栓塞有效。2例患者保守治疗治愈。2例患者死亡。结论是，对于创伤性血胆症的诊断，包括肝脏多普勒超声检查、食管胃十二指肠镜检查、选择性血管造影在内的综合检查是必要的。术后（创伤后）出现胃肠道出血症状的患者必须怀疑创伤性血胆症，其他出血来源的诊断并不能排除血胆症。选择性血管造影及肝动脉分支栓塞是治疗创伤性血胆症最有效、最安全的方法。
