2019 Volume 33 Issue 4 Pages 768-776
Case 1: A 66-years-old woman was hospitalized with melena during chemotherapy for pancreatic cancer. Although hemobilia was suspected with CT, it was not confirmed by ERCP. When she vomited blood on the 8th day, CT demonstrated pancreaticoduodenal artery aneurysm accompanied by biliary extravasation, which was considered as the cause of the hemobilia. Successful hemostasis was obtained with transarterial embolization (TAE). Case 2: A 67-years-old man was hospitalized with cholecystitis. He had been curatively treated with proton beam therapy for hepatocellular carcinoma with portal vein tumor thrombus. Although PTGBD was performed on the day of hospitalization, the bile turned bloody color the next day. A rupture of right hepatic artery aneurysm was confirmed with CT. Because TAE was difficult for the extensive portal vein thrombus, a coronary stent was placed and hemostasis was obtained.
Hemobilia is the complication that should be taken into consideration, along with progress and diversification of treatments for hepatobiliary pancreatic diseases.
