[Bilhemia--a review of diagnosis and therapy]

Bilhemia is a rare complication after liver injuries with high mortality. Clinical signs are rapid increase of direct and total bilirubin up to extreme values and increase of bile acids in serum. The reason is an intrahepatic connection between biliary and venous system. The bilio-venous fistula can be shown by ERCP and retrograde cholangiography via T-drainage. Localisation can be ensured by ultrasonography und computertomography. Treatment consists in resection of bilio-venous fistula, tamponade of intrahepatic cavities by use of a net of polyglactin-910 (Vicryl) or polyglycolic acid (Dexon) or sucking T-drainage.