Traumatic Hemobilia Associated with a Hepatoportal Biliary Fistula

The term traumatic hemobilia was suggested by Sandblom in 1948 although the condition was first described by Owen 100 years earlier in 1848. Owen 9 described a patient who, following blunt trauma to the liver, exhibited melena. The patient died, and at autopsy a deep laceration was demonstrated in the liver. The margins of the laceration were apposed and sealed against the diaphragm. Owen apparently surmised the relation between the patient's melena and the laceration in the liver but was looking for direct communication between the liver and the intestines, not realizing that the biliary ducts were the outflow tract for the bleeding. Later writers described and understood the mechanism of hemorrhage through the bile ducts. 4,5 In 1948 Sandblom 10 reported on 9 cases gathered from the foreign literature. He used the term traumatic hemobilia to describe hemorrhage into the bile ducts as the result of nonpenetrating trauma to