Hemobilia--successful treatment by angiographic embolization

Hemobilia after major liver trauma is a difficult problem to manage. We report a case of an 18-year-old male who sustained major liver trauma. Bleeding was controlled at laparotomy. Seventeen days after surgery hematemesis and intermittent bleeding from the drain occurred. Hepatic artery angiography demonstrated a pseudoaneurysm of one of the branches. Gelfoam embolization successfully controlled the bleeding. Review of the literature reveals that hemobilia has been treated by a conservative means as well as by surgery. Hepatic angiography to localize the site of bleeding and then embolization to control the hemorrhage now constitute the preferred method of treatment.