Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 21, 2012; 18(47): 7122-7126
Published online Dec 21, 2012. doi: 10.3748/wjg.v18.i47.7122
Successful disintegration, dissolution and drainage of intracholedochal hematoma by percutaneous transhepatic intervention
Jian-Jie Qin, Yong-Xiang Xia, Ling Lv, Zhao-Jing Wang, Feng Zhang, Xue-Hao Wang, Bei-Cheng Sun
Jian-Jie Qin, Yong-Xiang Xia, Ling Lv, Zhao-Jing Wang, Feng Zhang, Xue-Hao Wang, Bei-Cheng Sun, Liver Transplantation Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Jian-Jie Qin, Yong-Xiang Xia, Ling Lv, Zhao-Jing Wang, Feng Zhang, Xue-Hao Wang, Bei-Cheng Sun, Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing 210029, Jiangsu Province, China
Author contributions: All authors contributed equally to this study.
Supported by National Natural Science Foundation of China, No. 81072029 and No. 91029721; Program for New Century Excellent Talents in University, Ministry of Education of China, No. NCET-09-0160
Correspondence to: Bei-Cheng Sun, MD, PhD, Liver Transplantation Center, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. sunbc@njmu.edu.cn
Telephone: +86-25-68136476 Fax: +86-25-86560946
Received: July 10, 2012
Revised: August 13, 2012
Accepted: August 26, 2012
Published online: December 21, 2012
Abstract

Hemobilia is a rare biliary complication of liver transplantation. The predominant cause of hemobilia is iatrogenic, and it is often associated with traumatic operations, such as percutaneous liver intervention, endoscopic retrograde cholangiopancreatography, cholecystectomy, biliary tract surgery, and liver transplantation. Percutaneous transhepatic cholangiography and liver biopsy are two major causes of hemobilia in liver transplant recipients. Hemobilia may also be caused by coagulation defects. It can form intracholedochal hematomas, causing obstructive jaundice. Herein we describe a patient with an intracholedochal hematoma resulting in significant obstructive jaundice after liver transplantation for fulminant hepatic failure. Previous studies have shown that percutaneous transhepatic manipulation is a major cause of hemobilia after liver transplantation, but in our case, percutaneous transhepatic intervention was used to relieve the biliary obstruction and dissolve the biliary clot, with a good outcome.

Keywords: Hemobilia, Biliary clot, Fulminant hepatic failure, Percutaneous transhepatic biliary drainage