Endoscopy Challenge #3 - May '10

Discussion

Discussion:

Hemobilia, or bleeding from the biliary tract, is seldom seen in the pediatric population and is not one of the more commonly considered etiologies of upper gi bleeding. Causes for hemobilia are pooled from various case reports of children who endured blunt abdominal trauma, complications status post liver transplant with biliary strictures requiring balloon dilatation, liver abscess, and liver biopsy. US guided liver biopsies are safe but there are rare complications such as pseudoaneurysm and arterial-biliary fistula.1 The patient in this case report had a liver biopsy 2 weeks prior to presentation of abdominal pain, melanotic stools, and anemia.

Lillienne Yoon, MD, Fellow, University of Texas Southwestern
Brad Barth, MD, MPH, University of Texas Southwestern

References:
  1. Wood B, Pearson N, Crisp M, Neese P, Pohl JF. Pseudoaneurysm formation after ultrasound-guided liver biopsy in an obese child. South Med J. 2009 Apr;102(4):432-4.