Year 2024 / Volume 116 / Number 7
Letter
Recurrent hemobilia secondary to extrahepatic biliary tract cholangiocarcinoma. A diagnostic challenge

391-392

DOI: 10.17235/reed.2023.9922/2023

Raúl José Díaz Molina, Joaquín Fernández García, Sam Khorrami Minaei, Marco Antonio Martínez Ortega, Carmen Garrido Durán,

Abstract
The etiology of hemobilia has mainly iatrogenic (>50%), followed by traumatic causes. Others are biliopathy due to portal high pressure, or neoplastic or infective biliopathy. In the case of non-clear hemobilia, direct-vision-cholangioscopy can change the management in >34% of cases. Our patient had episodes of obstructive hemobilia with secondary cholangitis without objectifying underlying pathology. When she was referred to our center, SpyGlass®-cholangioscopy identified the suspicious lesion compatible with early-stage cholangiocarcinoma despite the diagnostic delay. In conclusion, it is important to keep in mind the neoformative etiology as a potential cause of hemobilia of unclear origin, in which case, cholangioscopy (SpyGlass®) can contribute to the recognition of the signs of malignancy of the lesion and, therefore, to the diagnosis.
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References
1. Zhornitskiy A, Berry R, Han JY et al. Hemobilia: Historical overview, clinical update, and current practices. Liver Int. 2019 Aug;39(8):1378-1388. doi: 10.1111/liv.14111.
2. Berry R, Han J, Girotra M et al. Hemobilia: Perspective and Role of the Advanced Endoscopist. Gastroenterol Res Pract. 2018 Jul 12;2018:3670739. doi: 10.1155/2018/3670739.
3. Parvinian A, Fletcher JG, Storm AC et al. Challenges in Diagnosis and Management of Hemobilia. Radiographics. 2021 May-Jun;41(3):802-813. doi: 10.1148/rg.2021200192.
4. Karagyozov P, Boeva I, Tishkov I. Role of digital single-operator cholangioscopy in the diagnosis and treatment of biliary disorders. World J Gastrointest Endosc. 2019 Jan 16;11(1):31-40. doi: 10.4253/wjge.v11.i1.31.
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Díaz Molina R, Fernández García J, Khorrami Minaei S, Martínez Ortega M, Garrido Durán C. Recurrent hemobilia secondary to extrahepatic biliary tract cholangiocarcinoma. A diagnostic challenge. 9922/2023


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Publication history

Received: 29/08/2023

Accepted: 12/09/2023

Online First: 26/10/2023

Published: 08/07/2024

Article Online First time: 58 days

Article editing time: 314 days


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