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Hemobilia: Perspective and Role of the Advanced Endoscopist

Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon cause of gastrointestinal hemorrhage. Hemobilia has been documented since the 1600s, but due to its relative rarity, it has only been more critically examined in recent decades. Most cases of hemobilia are iatrogenic...

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Autores principales: Berry, Rani, Han, James, Girotra, Mohit, Tabibian, James H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6079575/
https://www.ncbi.nlm.nih.gov/pubmed/30116262
http://dx.doi.org/10.1155/2018/3670739
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author Berry, Rani
Han, James
Girotra, Mohit
Tabibian, James H.
author_facet Berry, Rani
Han, James
Girotra, Mohit
Tabibian, James H.
author_sort Berry, Rani
collection PubMed
description Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon cause of gastrointestinal hemorrhage. Hemobilia has been documented since the 1600s, but due to its relative rarity, it has only been more critically examined in recent decades. Most cases of hemobilia are iatrogenic and caused by procedures involving the liver, pancreas, bile ducts, and/or the hepatopancreatobiliary vasculature, with trauma and malignancy representing the two other major causes. A classic triad of right upper quadrant pain, jaundice, and overt upper gastrointestinal bleeding has been described, but this is present in only 25–30% of patients with hemobilia. Historically, the gold standard for diagnosis and treatment has been angiography and interventional radiologic intervention, respectively. However, the paradigm is shifting, at least in select cases, towards first-line reliance on noninvasive imaging (e.g., computed tomography) and therapeutic endoscopy, owing to advances in and the less invasive nature of both, while saving interventional radiological and/or surgical intervention for refractory or imminently life-threatening cases.
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spelling pubmed-60795752018-08-16 Hemobilia: Perspective and Role of the Advanced Endoscopist Berry, Rani Han, James Girotra, Mohit Tabibian, James H. Gastroenterol Res Pract Review Article Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon cause of gastrointestinal hemorrhage. Hemobilia has been documented since the 1600s, but due to its relative rarity, it has only been more critically examined in recent decades. Most cases of hemobilia are iatrogenic and caused by procedures involving the liver, pancreas, bile ducts, and/or the hepatopancreatobiliary vasculature, with trauma and malignancy representing the two other major causes. A classic triad of right upper quadrant pain, jaundice, and overt upper gastrointestinal bleeding has been described, but this is present in only 25–30% of patients with hemobilia. Historically, the gold standard for diagnosis and treatment has been angiography and interventional radiologic intervention, respectively. However, the paradigm is shifting, at least in select cases, towards first-line reliance on noninvasive imaging (e.g., computed tomography) and therapeutic endoscopy, owing to advances in and the less invasive nature of both, while saving interventional radiological and/or surgical intervention for refractory or imminently life-threatening cases. Hindawi 2018-07-12 /pmc/articles/PMC6079575/ /pubmed/30116262 http://dx.doi.org/10.1155/2018/3670739 Text en Copyright © 2018 Rani Berry et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Berry, Rani
Han, James
Girotra, Mohit
Tabibian, James H.
Hemobilia: Perspective and Role of the Advanced Endoscopist
title Hemobilia: Perspective and Role of the Advanced Endoscopist
title_full Hemobilia: Perspective and Role of the Advanced Endoscopist
title_fullStr Hemobilia: Perspective and Role of the Advanced Endoscopist
title_full_unstemmed Hemobilia: Perspective and Role of the Advanced Endoscopist
title_short Hemobilia: Perspective and Role of the Advanced Endoscopist
title_sort hemobilia: perspective and role of the advanced endoscopist
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6079575/
https://www.ncbi.nlm.nih.gov/pubmed/30116262
http://dx.doi.org/10.1155/2018/3670739
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