Hemobilia presenting as lower gastrointestinal hemorrhage without pain or jaundice: a case report.

Hemobilia is a rare source of gastrointestinal (GI) hemorrhage. When hepatobiliary bleeding presents as GI bleeding, a history of preceding blunt abdominal trauma is reported in approximately 50% of cases. Often three to four weeks have elapsed between the injury and presentation, and as long as twelve weeks has been reported. Symptoms may suggest either upper or lower GI blood loss. Traumatic hemobilia is commonly associated with cavitary injuries to the liver, and is classically characterized by a triad of findings: GI bleeding, biliary colic, and jaundice. This report describes a patient with traumatic hemobilia, who had neither a significant hepatobiliary injury, nor the classic triad of findings.