Matches in SemOpenAlex for { <https://semopenalex.org/work/W2913251378> ?p ?o ?g. }
Showing items 1 to 79 of
79
with 100 items per page.
- W2913251378 endingPage "S1028" @default.
- W2913251378 startingPage "S1027" @default.
- W2913251378 abstract "Hemobilia is a rare cause of gastrointestinal bleeding (GI). Trauma, inflammatory conditions and iatrogenic injury are some causes; however it can also be a presenting manifestation of hepatobiliary malignancy. Diagnosis relies heavily on visual confirmation from various non-invasive and invasive imaging modalities. Case Report A 59-year-old woman with a history of hepatitis C, cirrhosis and hepatocellular carcinoma treated with Sorafenib, presented with abdominal pain, jaundice, and melena for five days. She denied hematemesis or fever. On presentation she was hemodynamically stable. Her hemoglobin had fallen to 7.5 g/dL from 11.1 g/dL six months earlier. Liver transaminases, total bilirubin and prothrombin time were all elevated. An abdominal computed tomography scan revealed liver cirrhosis with esophageal and gastric varices. Multifocal hepatic masses were also present without any radiographic findings of superimposed hemorrhage (Image 1A). Esophagogastroduodenoscopy demonstrated large non-bleeding esophageal varices with no red wale or nipple signs. Close examination of the ampulla demonstrated active bleeding from the papilla (Image 1B). Variceal banding was not performed. After discussion with interventional radiology, conservative management including reversal of coagulopathy was the mainstay of treatment. She was discharged two days later in stable condition. Conclusion Quincke's triad consisting of biliary colic, melena and obstructive jaundice is pathognomonic of hemobilia. The etiology of hemobilia includes trauma, iatrogenic injury, inflammatory conditions and coagulopathy. Depending on the rate of bleeding, obstruction of the biliary tree can occur by clot formation. Transarterial embolization is the first line of therapy while endoscopic retrograde cholangiopancreatography best manages biliary obstruction. Complications of transarterial embolization include tumor necrosis, hepatic decompensation and post-embolization syndrome. Given our patient's hemodynamic stability, embolization was thus avoided. The importance of examining the papilla in this case was also demonstrated. Failure to identify the cause of bleeding and unnecessary variceal banding was avoided with a thorough endoscopy. Hemobilia is an uncommon cause of GI bleeding and a challenge to recognize. Early recognition can be facilitated with a thorough endoscopy.Figure: Abdominal CT demonstrating a cirrhotic liver, with a hypodense hepatoma within the right lobe of the liver (arrow).Figure: Esophagogastroduodenoscopy image of the second part of duodenum demonstrating fresh blood within the duodenum." @default.
- W2913251378 created "2019-02-21" @default.
- W2913251378 creator A5000866708 @default.
- W2913251378 creator A5013883645 @default.
- W2913251378 creator A5019127943 @default.
- W2913251378 creator A5029622912 @default.
- W2913251378 creator A5016044800 @default.
- W2913251378 date "2017-10-01" @default.
- W2913251378 modified "2023-10-16" @default.
- W2913251378 title "A Triad to Identify an Uncommon Etiology of Gastrointestinal Bleeding" @default.
- W2913251378 doi "https://doi.org/10.14309/00000434-201710001-01869" @default.
- W2913251378 hasPublicationYear "2017" @default.
- W2913251378 type Work @default.
- W2913251378 sameAs 2913251378 @default.
- W2913251378 citedByCount "0" @default.
- W2913251378 crossrefType "journal-article" @default.
- W2913251378 hasAuthorship W2913251378A5000866708 @default.
- W2913251378 hasAuthorship W2913251378A5013883645 @default.
- W2913251378 hasAuthorship W2913251378A5016044800 @default.
- W2913251378 hasAuthorship W2913251378A5019127943 @default.
- W2913251378 hasAuthorship W2913251378A5029622912 @default.
- W2913251378 hasConcept C126322002 @default.
- W2913251378 hasConcept C126838900 @default.
- W2913251378 hasConcept C141071460 @default.
- W2913251378 hasConcept C2775967933 @default.
- W2913251378 hasConcept C2776345487 @default.
- W2913251378 hasConcept C2777214474 @default.
- W2913251378 hasConcept C2777424391 @default.
- W2913251378 hasConcept C2777595160 @default.
- W2913251378 hasConcept C2778080469 @default.
- W2913251378 hasConcept C2778444009 @default.
- W2913251378 hasConcept C2778451229 @default.
- W2913251378 hasConcept C2778456037 @default.
- W2913251378 hasConcept C2778808290 @default.
- W2913251378 hasConcept C2779388726 @default.
- W2913251378 hasConcept C2780955771 @default.
- W2913251378 hasConcept C2780970735 @default.
- W2913251378 hasConcept C2781143854 @default.
- W2913251378 hasConcept C71924100 @default.
- W2913251378 hasConcept C90924648 @default.
- W2913251378 hasConceptScore W2913251378C126322002 @default.
- W2913251378 hasConceptScore W2913251378C126838900 @default.
- W2913251378 hasConceptScore W2913251378C141071460 @default.
- W2913251378 hasConceptScore W2913251378C2775967933 @default.
- W2913251378 hasConceptScore W2913251378C2776345487 @default.
- W2913251378 hasConceptScore W2913251378C2777214474 @default.
- W2913251378 hasConceptScore W2913251378C2777424391 @default.
- W2913251378 hasConceptScore W2913251378C2777595160 @default.
- W2913251378 hasConceptScore W2913251378C2778080469 @default.
- W2913251378 hasConceptScore W2913251378C2778444009 @default.
- W2913251378 hasConceptScore W2913251378C2778451229 @default.
- W2913251378 hasConceptScore W2913251378C2778456037 @default.
- W2913251378 hasConceptScore W2913251378C2778808290 @default.
- W2913251378 hasConceptScore W2913251378C2779388726 @default.
- W2913251378 hasConceptScore W2913251378C2780955771 @default.
- W2913251378 hasConceptScore W2913251378C2780970735 @default.
- W2913251378 hasConceptScore W2913251378C2781143854 @default.
- W2913251378 hasConceptScore W2913251378C71924100 @default.
- W2913251378 hasConceptScore W2913251378C90924648 @default.
- W2913251378 hasLocation W29132513781 @default.
- W2913251378 hasOpenAccess W2913251378 @default.
- W2913251378 hasPrimaryLocation W29132513781 @default.
- W2913251378 hasRelatedWork W1841582673 @default.
- W2913251378 hasRelatedWork W2182982353 @default.
- W2913251378 hasRelatedWork W2460709410 @default.
- W2913251378 hasRelatedWork W2948138812 @default.
- W2913251378 hasRelatedWork W3029704774 @default.
- W2913251378 hasRelatedWork W3176018642 @default.
- W2913251378 hasRelatedWork W3193927522 @default.
- W2913251378 hasRelatedWork W4290273407 @default.
- W2913251378 hasRelatedWork W4319337342 @default.
- W2913251378 hasRelatedWork W2910086967 @default.
- W2913251378 hasVolume "112" @default.
- W2913251378 isParatext "false" @default.
- W2913251378 isRetracted "false" @default.
- W2913251378 magId "2913251378" @default.
- W2913251378 workType "article" @default.