ISSN:
1432-0509
Keywords:
Aneurysm, rupture
;
Hepatic arteries, therapeutic blockade
;
Bile ducts, hemorrhage
;
Bile ducts, injuries
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Ten patients with massive hemobilia in shock or preshock status were treated with angiography. The hemobilia had been induced by iatrogenic trauma: biliary drainage in seven patients, and surgery, liver biopsy, and angiography in one patient each. Angiography was performed on all patients. Embolization was performed in nine, and in the one remaining patient, spasm of the right anterior hepatic artery and catheter manipulation injured the intima and obliterated the artery. In seven patients with hepatic artery pseudoaneurysm, gelfoam particles were injected in five, however, extravasation could not be prevented in four of these patients. Permanent embolic materials were added and complete hemostatis was obtained. Hemobilia never recurred in any patient. Emergency embolization should be considered as the initial treatment of choice for hemobilia and when pseudoaneurysms are discovered, they should be obliterated by permanent embolic materials. Moreover, tumor thrombus in the portal vein is not a contraindication for this procedure.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01887347
Permalink