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September 1972

Hemobilia Secondary to Percutaneous Liver Biopsy

Author Affiliations

Nashville, Tenn; Sydney, Australia; Nashville, Tenn

From the departments of medicine (Drs. Levinson, Terman, and Cleaveland), gastroenterology (Drs. Levinson and Breen), pharmacology (Dr. Cleaveland), and surgery (Dr. Graham), Vanderbilt University School of Medicine, Nashville, Tenn; and the Department of Gastroenterology, Royal Prince Alfred Hospital, Sydney, Australia (Dr. Olsen). Dr. Levinson is now with the Center for Internal Medicine, Springfield, NJ.

Arch Intern Med. 1972;130(3):396-400. doi:10.1001/archinte.1972.03650030074018

Hemobilia, or hemorrhage into the biliary tract,1 is most commonly caused by aneurysms of the hepatic artery2 or by blunt abdominal injury leading to liver trauma.3 Other causes of massive hemobilia are unusual but include primary hepatoma,4 gallbladder tumors,5 foreign bodies, eg, T-tubes,6 biliary stones,7 acute hemorrhagic cholecystitis,8 and liver hemangioma.9

Percutaneous needle biopsy of the liver, another form of liver trauma,10 has been reported only once previously as a cause of hemobilia.11 This report concerns three cases of hemobilia secondary to liver biopsy. As delay in diagnosis or failure to diagnose this condition may adversely affect the patients outcome, we emphasize the clinical features which should lead one to suspect hemobilia and the diagnostic procedures which can be used to localize the source of bleeding prior to operative intervention.

Patient Summaries 

Patient 1.  —A 40-year-old man was admitted

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