Treatment of haemobilia by selective arterial embolisation.

Abstract

We report a patient in whom haemobilia occurred after percutaneous liver biopsy. Selective hepatic arteriography showed a fistula between hepatic artery and portal venous system, with appearance of contrast in the biliary tract. Intrahepatic bleeding was stopped by arterial embolisation with a mixture of gelatine foam and sterile dura mater. Cholecytectomy was subsequently required as a haemocholecyst developed. The technique of arteriography and embolisation allows accurate localisation of intrahepatic bleeding sites and may avoid the need for a direct surgical approach to this problem.