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J Clin Gastroenterol ; 51(9): 796-804, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28644311

RESUMO

GOAL AND BACKGROUND: A literature review to improve practitioners' knowledge and performance concerning the epidemiology, diagnosis, and management of hemobilia. STUDY: A search of Pubmed, Google Scholar, and Medline was conducted using the keyword hemobilia and relevant articles were reviewed and analyzed. The findings pertaining to hemobilia etiology, investigation, and management techniques were considered and organized by clinicians practiced in hemobilia. RESULTS: The majority of current hemobilia cases have an iatrogenic cause from either bile duct or liver manipulation. Blunt trauma is also a significant cause of hemobilia. The classic triad presentation of right upper quadrant pain, jaundice, and upper gastrointestinal bleeding is rarely seen. Computed tomography and magnetic resonance imaging are the preferred diagnostic modalities, and the preferred therapeutic management includes interventional radiology and endoscopic retrograde cholangiopancreatography. Surgery is rarely a therapeutic option. CONCLUSIONS: With advances in computed tomography and magnetic resonance imaging technology, diagnosis with these less invasive investigations are the favored option. However, traditional catheter angiography is still the gold standard. The management of significant hemobilia is still centered on arterial embolization, but arterial and biliary stents have become accepted alternative therapies.


Assuntos
Ductos Biliares/lesões , Hemorragia Gastrointestinal/epidemiologia , Hemobilia/epidemiologia , Doença Iatrogênica , Ferimentos não Penetrantes/epidemiologia , Ductos Biliares/diagnóstico por imagem , Procedimentos Cirúrgicos do Sistema Biliar , Colangiopancreatografia Retrógrada Endoscópica/instrumentação , Embolização Terapêutica , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/terapia , Hemobilia/diagnóstico por imagem , Hemobilia/terapia , Humanos , Valor Preditivo dos Testes , Radiografia Intervencionista , Fatores de Risco , Stents , Resultado do Tratamento , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/terapia
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