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Haemobilia

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Haemobilia

5
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. 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
Q. 3

Hemobilia is best treated with:

 A

Arterial embolisation
 B

Ablative therapy
 C

Argon laser coagulation
 D

None of the above
Q. 4

All are seen in hemobilia except –

 A

Shock
 B

Colicky pain
 C

Melena
 D

Jaundice
Q. 5

Triad of hemobilia includes all, EXCEPT ‑

 A

Pain
 B

Fever
 C

G.I. bleeding
 D

Jaundice
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.