UPPER gastrointestinal hemorrhage is always serious and its source can usually be determined by preoperative study or laparotomy; yet in some cases its precise localization eludes the most intensive investigation.
Recently a patient was treated for massive upper gastrointestinal bleeding due to hemobilia arising from an intrahepatic aneurysm of the hepatic artery. Because of its rarity, unusual symptoms, variable laboratory data, and documented pathology, this case is reported.
Report of a Case
A 76-year-old white female was admitted to the hospital because of weakness. On the day of admission she experienced nausea, diaphoresis, and severe epigastric pain for a half hour. Six hours later she was found in a cold sweat, confused, and immobile.Three months prior to this episode, she had melena and anemia which were unexplained despite intensive study in the hospital. Her hemoglobin was 6.8 gm/100 ml; hematocrit, 22%; a serum iron, 27μ/100 ml; and a reticulocyte
Tetreault AF, Bowen JR, Sampaio N. Hemobilia Secondary to Intrahepatic Aneurysm of the Hepatic Artery: Report of a Case With Clinical and Pathological Correlations. JAMA. 1965;192(12):1096–1098. doi:10.1001/jama.1965.03080250074022
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