Hemobilia Secondary to Percutaneous Liver Biopsy

Hemobilia, or hemorrhage into the biliary tract,1is most commonly caused by aneurysms of the hepatic artery2or by blunt abdominal injury leading to liver trauma.3Other causes of massive hemobilia are unusual but include primary hepatoma,4gallbladder tumors,5foreign bodies, eg, T-tubes,6biliary stones,7acute hemorrhagic cholecystitis,8and liver hemangioma.9 Percutaneous needle biopsy of the liver, another form of liver trauma,10has been reported only once previously as a cause of hemobilia.11This report concerns three cases of hemobilia secondary to liver biopsy. As delay in diagnosis or failure to diagnose this condition may adversely affect the patients outcome, we emphasize the clinical features which should lead one to suspect hemobilia and the diagnostic procedures which can be used to localize the source of bleeding prior to operative intervention. Patient Summaries Patient 1. —A 40-year-old man was admitted