Most common cause of hemobilia is -
Ans. is 'b' i.e., Iatrogenic trauma o Hemobilia is defined as bleeding into the biliary' tree from an abnormal communication between a blood vessel and bile duct.Causes of hemobiliaTrauma (most common)Iatrogenic trauma is the most common cause.(includes interventional radiological procedures, percutaneous liver biopsy, percutaneous transhepatic biliary drainage, operations on gallbladder and bile duct).Blunt trauma is more common cause than penetrating trauma.Gall stonesVascular pathologies - aneurysms, angiodysplasias, hemangiomas.Uncommon causesMalignant tumors of liver, biliary' tree, gall bladder, pancreasParasitic infectionHeaptic abscessCholangitisAcalculus cholecystitisClinical presentationo Classical triad consists ofUpper abdominal pain (biliary colic)Obstructive jaundice (obstruction by blood clots)Upper gastrointestinal haemorrhageHematemesisMelenaDiagnosiso Diagnosis of hemobilia is typically made on upper endoscopy with findings of bleeding from the ampulla of vater.o Arterial angiography is the investigation of choice as it will reveal the source of bleeding in about 90% of cases,o ManagementMinor hemobilia can be managed conservatively.For major hemobilia transarterial embolization (TAE) is first line of therapy.Surgery is indicated when TAE has failed, it consists of:# Ligation of bleeding vessels, excision of aneurysms, or nonselective ligation of a main hepatic artery.
Carcinoma
Iatrogenic trauma
Blunt trauma
Cirrhosis
Miscellaneous (Gall Bladder & Bile Ducts)