Konerman Monica A, Zhang Zishu, Piraka Cyrus
Division of Gastroenterology, University of Michigan Hospital, Ann Arbor, Michigan.
Department of Radiology, University of Michigan Hospital, Ann Arbor, Michigan.
ACG Case Rep J. 2016 Dec 7;3(4):e170. doi: 10.14309/crj.2016.143. eCollection 2016 Aug.
Hemobilia represents an uncommon cause of gastrointestinal bleeding that can present both diagnostic and therapeutic challenges. The evaluation of hemobilia typically involves cross-sectional imaging and endoscopic retrograde cholangiopancreatography (ERCP). There is limited data regarding the diagnostic utility of endoscopic ultrasound (EUS) in the evaluation of hemobilia. We present a case of a hepatic artery pseudoaneurysm as the etiology of hemobilia that was detected via EUS only. We conclude that EUS can serve as an important diagnostic tool in the evaluation of obscure hemobilia, especially in cases where imaging, ERCP, and percutaneous transhepatic cholangiography have been unsuccessful or inconclusive.
胆道出血是胃肠道出血的一种罕见原因,会带来诊断和治疗方面的挑战。胆道出血的评估通常涉及横断面成像和内镜逆行胰胆管造影(ERCP)。关于内镜超声(EUS)在胆道出血评估中的诊断效用的数据有限。我们报告一例以肝动脉假性动脉瘤为病因的胆道出血病例,该病例仅通过EUS检测到。我们得出结论,EUS可作为评估不明原因胆道出血的重要诊断工具,尤其是在成像、ERCP和经皮经肝胆管造影均未成功或结果不确定的情况下。