Federica Libra, Serafino Santonocito, Daniele Falsaperla, Giovanni Failla, Stefano Palmucci, Antonio Basile
Department of Medical Surgical Sciences and Advanced Technologies - Radiology I Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, Catania, 95123, Italy.
Radiol Case Rep. 2021 Jan 8;16(3):693-697. doi: 10.1016/j.radcr.2020.12.067. eCollection 2021 Mar.
Haemobilia is defined as bleeding from the biliary system due to abnormal communication between a blood vessel and the bile ducts. Melena or hematemesis, abdominal pain and jaundice represent the pathognomonic triad for haemobilia, but clinical presentation and aetiology of this entity are extremely variable. We report a case of a 50-year-old man with melena and anaemia and a clinical history of multivalvular endocarditis in which an extremely rare presence of 2 uncommon causes of haemobilia was found, such as a mycotic pseudoaneurysm and a giant hepatic haemangioma, both treated by transarterial embolization. In the management of haemobilia, TAE has been proven to be the treatment of choice because it combines a diagnostic angiography with therapeutic intervention in a minimally invasive, safe and effective way. Physician and radiologist should keep in mind also the uncommon aetiologies of haemobilia, knowing that the source of bleeding could be more than just one.
胆道出血定义为因血管与胆管之间的异常交通导致的胆道系统出血。黑便或呕血、腹痛和黄疸是胆道出血的典型三联征，但该病症的临床表现和病因极为多样。我们报告一例50岁男性患者，有黑便和贫血症状，并有多瓣膜心内膜炎病史，该病例中发现了两种极为罕见的胆道出血罕见病因，即霉菌性假性动脉瘤和巨大肝血管瘤，二者均通过经动脉栓塞治疗。在胆道出血的治疗中，经动脉栓塞已被证明是首选治疗方法，因为它以微创、安全且有效的方式将诊断性血管造影与治疗干预相结合。医生和放射科医生也应牢记胆道出血的罕见病因，要知道出血源可能不止一个。
