Hemobilia. A case report

We present the case of a 88 years old male, with a history of melena, demonstrated by repeated endoscopies to be secondary to hemobilia, and after endoscopic retrograde cholangiopancreatography we could demonstrate the presence of bleeding intraductal choledocus polyps with histopathological report of intraepithelial adenoma. Hemobilia is a rare cause of upper gastrointestinal hemorrhage with an increasing incidence because of the widespread use of invasive hepatobiliary procedures and improved recognition. In the majority of cases the cause is iatrogenic. The classical presentation of hemobilia is with biliary colic, jaundice, hematemesis, and melena. The diagnosis and evaluation of hemobilia is facilitated by the use of sonography, computed tomography and endoscopic retrograde cholangiopancreatography. Persistent bleeding sometimes requires urgent therapeutic intervention, such as angiography or surgery.