Abstract
A 62-year-old man with hepatocellular carcinoma (HCC) was admitted to our hospital with complaints of right hypochondrial pain, fever up and melena. Severe anemia was found by peripheral blood examination (Hb 5.8 g/dl). We could not detect the bleeding lesion by 1 st endoscopic and colonoscopic examination. However, at day 21, right hypochondrial pain and melena was occured again, so we performed the second endoscopic examination in order to detect a bleeding lesion. We diagnosed this bleeding as a hemobilia because of findings of active bleeding from the papilla of Vater. Transcatheter arterial embolization (TAE) was carried out and it could control the bleeding successfully and no rebleeding occurred until his death 5 months later. We considered that this is a case of hemobilia due to intrahepatic bile duct tumor growth of HCC.
TAE for the treatment of hemobilia was first described by Walter et al. in 1976, and recently this procedure has come to be the treatment of first choice for hemobilia. However, to the best of our knowledge, this might be a rare case whose hemobilia due to invasive growth of HCC into intrahepatic bile duct was controlled by TAE successfully.
