Traumatic haemobilia treated by hepatic artery ligation

A 22-year-old woman developed haemobilia following suture of an apparently superficial liver injury. The diagnosis was made on the basis of the clinical features, duodenoscopy, and liver function test. Selective hepatic angiography and liver scintiscan demonstrated a cavity in the right lobe on the liver, with the bleeding arising from a branch of the right hepatic artery. She was treated by cholescystectomy, exploration of the common bile duct with removal of clots, and ligation of the right hepatic artery. Subsequent T tube cholangiography and liver scintiscans demonstrated complete resolution of the cavity, and there was no further bleeding. Experience with this patient suggests that contrary to previous recommendations, haemobilia associated with an intrahepatic cavity may be successfully treated by hepatic artery ligation.