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[A child with traumatic hemobilia]

J E M Werner1, R M H Wijnen, L J Schultze Kool

  • 1Universitair Medisch Centrum St Radboud, Nijmegen.

Nederlands Tijdschrift Voor Geneeskunde
|July 29, 2004
PubMed

Insights

A child sustained liver trauma from a car accident, later developing hemobilia due to a pseudoaneurysm. Prompt diagnosis and embolization were crucial for successful treatment of this rare complication.

Area of Science:

  • Pediatric Surgery
  • Vascular Surgery
  • Diagnostic Imaging

Background:

  • A 4-year-old boy experienced severe abdominal trauma after being hit by a car.
  • Initial management focused on stabilizing hemodynamic instability and addressing liver rupture and duodenal hematoma.

Observation:

  • The patient presented with recurrent abdominal pain and gastrointestinal bleeding one and two months post-trauma.
  • Initial symptoms were attributed to a Meckel's diverticulum, which was surgically removed.

Findings:

  • Magnetic Resonance Imaging (MRI) and angiography revealed a ruptured pseudoaneurysm of the proper hepatic artery, leading to the diagnosis of hemobilia.
  • The pseudoaneurysm was successfully treated with embolization.

Implications:

  • This case highlights the importance of considering hemobilia in pediatric patients with a history of abdominal trauma presenting with gastrointestinal hemorrhage and biliary symptoms.
  • Delayed diagnosis of hemobilia can lead to significant morbidity; prompt diagnostic workup including advanced imaging is essential.

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