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Hemobilia in childhood
G Läckgren1, L E Lörelius, L Olsen
1Department of Pediatric Surgery, University Hospital, Uppsala, Sweden.
Insights
Selective arterial embolization effectively treats hemobilia in children following blunt abdominal trauma. This minimally invasive procedure offers a safe and successful alternative for managing gastrointestinal bleeding and jaundice.
Area of Science:
- Pediatric Surgery
- Interventional Radiology
- Trauma Management
Background:
- Hemobilia, or bleeding into the biliary system, is a rare complication of blunt abdominal trauma.
- Classical symptoms include gastrointestinal bleeding, abdominal pain, and jaundice, posing significant clinical challenges in pediatric patients.
Observation:
- Three pediatric cases of hemobilia secondary to blunt abdominal trauma were observed over a decade.
- One 5-year-old boy experienced recurrent severe gastrointestinal bleeding, pain, and jaundice for two months.
Findings:
- Selective arterial embolization of the left hepatic artery was performed on the symptomatic pediatric patient.
- The procedure provided immediate symptom relief, and the patient remained healthy for over two years.
Implications:
- Selective arterial embolization is a safe and effective treatment for hemobilia in children, with minimal risk of liver dysfunction.
- Hepatic artery embolization should be considered the primary treatment for pediatric hemobilia, even in young children.
Abstract:
During a 10-year period we have encountered three cases of hemobilia among children after blunt abdominal trauma. All patients had the classical symptoms with varying degrees of severity. One of the patients, a 5-year-old boy, had several episodes of severe gastrointestinal bleeding, abdominal pain, and jaundice during a 2-month period. He was treated with selective arterial embolization of the left hepatic artery. The symptoms ceased instantly, and the patient has remained healthy during an observation period of more than 2 years. In cases of hemobilia, selective arterial embolization is a safe method with no serious complications. Arterial collaterals develop very quickly and the risk of liver dysfunction is small. We suggest that embolization of hepatic arteries may be the treatment of choice even in small children with hemobilia.