Hemobilia as the initial manifestation of cholangiocarcinoma in a hemophilia B patient.

Abstract

Hemobilia is a rare manifestation of hemophilia and is usually iatrogenic following liver biopsy. There are only few reports of spontaneous hemobilia in hemophilia patients. Cholangiocarcinoma is a well-established cause of hemobilia. We describe a case of a 70-year-old male, with known haemophilia B and a past history of papillotomy, who presented with classical symptoms of hemobilia. The initial diagnostic work-up failed to demonstrate a potential cause of bleeding other than the coagulopathy. Three months later, he was readmitted to our hospital with a second episode of hemobilia. During the second work-up, a cholangiocarcinoma was diagnosed both by imaging studies and by a significant elevation of cancer antigen 19-9. Although hemobilia could be attributed to hemophilia, especially in a patient with previous papillotomy, an underlying malignancy of the biliary tree should be suspected.

• Authors: Anastassios-C Manolakis, Andreas-N Kapsoritakis, Antonis-D Tsikouras, Fotis-D Tsiopoulos, Athanassios-K Psychos, Spyros-P Potamianos
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 14 Issue 26 Pg. 4241-4 (Jul 14 2008) ISSN: 1007-9327 [Print] United States
• PMID: 18636674 (Publication Type: Case Reports, Journal Article)

Chemical References

• CA-19-9 Antigen

Topics

• Aged
• Bile Duct Neoplasms (complications, diagnosis)
• Bile Ducts, Intrahepatic
• CA-19-9 Antigen (blood)
• Cholangiocarcinoma (complications, diagnosis)
• Cholangiopancreatography, Endoscopic Retrograde
• Cholangiopancreatography, Magnetic Resonance
• Hemobilia (etiology)
• Hemophilia B (complications)
• Humans
• Male