Nonoperative management of hemobilia

Traumatic hemobilia is an uncommon complication of blunt or penetrating liver injury and is characterized by jaundice, biliary colic, gastrointestinal hemorrhage, and a recent history of abdominal trauma. The clinical diagnosis of hemobilia is confirmed by endoscopy and selective arteriography. Selective hepatic artery angiography will locate the site of bleeding, and determine the extent of liver injury. The choice of treatment of hemobilia depends on the severity of the hemorrhage and the extent of injury. The treatment of massive or persistent hemobilia is surgical drainage of hematoma and ligation of bleeding sites. Non-massive hemobilia may be treated conservatively with liver healing documented by serial selective arteriograms. The nonoperative treatment of a case of non-massive hemobilia with a good result is presented.