Porto-biliary fistula as an uncommon cause of haemobilia: A case report and literature review

Valentina Galvis, Daniela Ayala, Juliana González T, Carlos Eduardo Rey Chaves, Danny Conde, German Gomez, Juan Carlos Sabogal Olarte

Producción científica: Contribución a una revistaArtículorevisión exhaustiva

Resumen

BACKGROUND: Haemobilia is a rare cause of gastrointestinal bleeding. It can be related to iatrogenic injuries, inflammatory diseases, and, more recently, postoperative, or post-procedure complications. Porto-biliary fistula is an uncommon case of haemobilia and has been related to iatrogenic injury or chronic inflammatory processes. To date, less than 30 cases of Porto-biliary fistula have been reported.

CASE PRESENTATION: We present a 53 years-old woman with a history of biliary obstruction due to a choledochal cyst that required hepaticojejunostomy with evidence of anastomotic stricture. A percutaneous transhepatic biliary drainage (PTBD) was performed, with 3 failed attempts of percutaneous dilatation. A new hepaticojejunostomy was completed, however, 45 days later the patient presented to the emergency room with haemobilia and secondary hemodynamic instability. An emergency damage control laparotomy was performed, achieving bleeding control. In the second procedure, there is evidence of an ulcerative injury of the biliary tract secondary to a Porto-biliary fistula.

CONCLUSION: Porto-biliary fistula is an entity that cannot be ruled out in cases of haemobilia, especially in cases with a history of bile duct surgical or percutaneous procedures. The prognosis is usually good if multidisciplinary management is performed, and the source of the bleeding is identified early.

Idioma originalInglés
Número de artículo107635
Páginas (desde-hasta)107635
PublicaciónInternational Journal of Surgery Case Reports
Volumen99
DOI
EstadoPublicada - oct. 2022

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