Diagnosis of nontraumatic hematobilia by computerized tomography of the abdomen.

Hematobilia was diagnosed by computerized tomography as the cause of gastrointestinal bleeding in a 73-yr-old man. The patient suffered from recurrent abdominal pain for 4 yr and presented with a history of episodic hematochezia over the previous 24 h, suggestive of significant lower gastrointestinal bleeding. Endoscopic evaluation of the lower and upper gastrointestinal tract revealed only blood in the region of a normal ampulla. Computerized tomography demonstrated a thickened gallbladder filled with material the density of blood. A blood-filled gallbladder was removed at cholecystectomy and pathological examination of the excised gallbladder demonstrated ulceration and inflammation of the mucosa. The diagnostic evaluation of hematobilia is discussed.