Haemobilia

Haemobilia

Q. 1 All of the following are causes of hemobilia, EXCEPT:

 A Trauma to Abdomen

 B

Malignancy

 C

Rupture of hepatic artery aneurysm

 D

Hepatitis

Q. 1

All of the following are causes of hemobilia, EXCEPT:

 A

Trauma to Abdomen

 B

Malignancy

 C

Rupture of hepatic artery aneurysm

 D

Hepatitis

Ans. D

Explanation:

Hemobilia presents with the triad of biliary colic, obstructive jaundice, and occult or gross intestinal bleeding.

Etiology-

  • Trauma:

– Iatrogenic trauma (PTC) is the MC cause
– Blunt trauma is more common cause than penetrating trauma

  • Gallstones
  • Vascular pathology: Aneurysm, angiodysplasia, hemangioma
  • Uncommon causes: Malignancy, parasitic infestation, liver abscess, cholangitis

Q. 2 Hemobilia patients presents with GI bleeding and elevated liver biochemical tests. The diagnosis is confirmed by:

 A

Side viewing duodenoscope

 B

CECT abdomen

 C

USG abdomen

 D

Laparotomy

Ans. A

Explanation:

Hemobilia
Occur in patients with liver trauma, undergone a liver biopsy, manipulation of the hepatobiliary system, as occurs with endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography, or TIPS, or have hepatocellular carcinoma or a biliary parasitic infection.
 
SYMPTOMS:
Patient present with a combination of GI bleeding and elevated liver biochemical test levels.
 
INVESTIGATION:
The diagnosis is confirmed by a side-viewing duodenoscope to identify bleeding from the ampulla 
TREATMENT:
 
Arterial embolization via arteriography
 
Ref: Sleisenger and Fordtran’s, E-9, P-301.

 


Q. 3

Hemobilia is best treated with:

 A

Arterial embolisation

 B

Ablative therapy

 C

Argon laser coagulation

 D

None of the above

Ans. A

Explanation:

Hemobilia 
Occur in patients with liver trauma, undergone a liver biopsy, manipulation of the hepatobiliary system, as occurs with endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography, or TIPS, or have hepatocellular carcinoma or a biliary parasitic infection.
SYMPTOMS:
Patient present with a combination of GI bleeding and elevated liver biochemical test levels.
INVESTIGATION :
The diagnosis is confirmed by a side-viewing duodenoscope to identify bleeding from the ampulla 
TREATMENT:
Arterial embolization via arteriography
 
Ref:Sleisenger and Fordtran’s,E-9,P-301.
 

Q. 4

All are seen in hemobilia except –

 A

Shock

 B

Colicky pain

 C

Melena

 D

Jaundice

Ans. A

Explanation:

Ans. is ‘a’ i.e., Shock

  • The classic triad of symptoms and signs of hemobilia are upper abdominal pain, upper gastrointestinal hemorrhage, and jaundice.
  • The symptoms and signs of major hemobilia are melena (90% of cases), hematemesis (60% of cases), biliary colic (70% of cases), and jaundice (60% of cases).
  • Upper gastrointestinal bleeding seen in conjunction with biliary symptoms must always raise the suspicion of hemobilia.

Q. 5 Triad of hemobilia includes all, EXCEPT ‑

 A

Pain

 B

Fever

 C

G.I. bleeding

 D

Jaundice

Ans. B

Explanation:

Ans.B. Fever

The classic triad of symptoms and signs of hemobilia are upper abdominal pain, upper gastrointestinal hemorrhage, and jaundice.



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