Honoré C, Dondelinger R F
Chirurgie générale, CHU Sart Tilman, Liège.
Rev Med Liege. 2007 Sep;62(9):536-8.
Hemobilia or hematobilia is defined by bleeding inside the bile duct. Although rare and misunderstood, it may evolve a life-threatening condition and its frequency is increasing. Clinical presentation commonly includes upper gastrointestinal bleeding, biliary colic and jaundice. The diagnosis must be suggested in a patient with a history of hepatic surgery, trauma or invasive biliary intervention. Key investigation is selective angiogram which allows us to confirm the diagnosis, locate and in most cases treat the vascular lesion responsible of hemobilia. Surgery should remain limited to extra-hepatic or gallbladder bleeding and in case of a failure of intra-vascular embolization.
胆道出血或血胆症是由胆管内出血所定义的。尽管罕见且易被误解,但它可能发展为危及生命的状况,且其发生率正在上升。临床表现通常包括上消化道出血、胆绞痛和黄疸。对于有肝脏手术、外伤或侵入性胆道干预病史的患者,必须考虑到该诊断。关键的检查是选择性血管造影,它能使我们确诊、定位并在大多数情况下治疗导致胆道出血的血管病变。手术应仅限于肝外或胆囊出血以及血管内栓塞失败的情况。