Hémobilies : étiologies et place de l'imagerie diagnostique et interventionnelle dans la prise en charge

Hemobilia is an uncommon cause of upper gastrointestinal bleeding. Abdominal pain and jaundice are also described in the classic triad of symptoms. The most commonly encountered etiologies of hemobilia are iatrogenic, mostly as a consequence of percutaneous transhepatic procedures. Side-viewing duodenoscopy can provide evidence of bleeding from the major duodenal papilla. Multiphasic abdominal computed tomography is helpful to identify the cause of bleeding (artery pseudoaneurysm, portal arteriovenous fistula, liver or biliary malignant tumor) and to guide therapeutic management. Celiomesenteric transfemoral angiography is mostly performed for selective arterial embolization of vascular lesion.