June 1966

Traumatic Intrahepatic Hemobilia

Author Affiliations

From the departments of surgery, Baltimore City Hospitals and the Johns Hopkins University School of Medicine, Baltimore. Dr. Steichen is presently at Lincoln Hospital, Albert Einstein College of Medicine, Bronx, NY 10454. Dr. Sheiner is presently at the Jewish General Hospital, Montreal 26, P.Q., Canada.

Arch Surg. 1966;92(6):838-847. doi:10.1001/archsurg.1966.01320240026006

THE OCCURRENCE of bleeding into the gastrointestinal tract from the hepatobiliary system is referred to as hemobilia, a term introduced by Sandblom1 in 1948. Although the condition can be caused in a multitude of ways, the present report is concerned with external trauma to the liver as the etiological factor—traumatic intrahepatic hemobilia. Cases of intrahepatic hemobilia complicating operations on the biliary tree are not included.2-6

Similarly, patients presenting with a history of adequate external trauma but lacking some of the clinical and operative features or postmortem confirmation of the disease are excluded.7-16a

It was because of the similarity of this condition to hematuria in kidney injuries that Sandblom introduced the term hemobilia. He implied that it occurs most frequently in central fractures of the liver, leaving the capsule intact. It may, in fact, be associated more often with liver lacerations that include the capsule and on rare

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