Bilhemia after trans-jugular intra-hepatic porto-systemic shunt and its management with biliary decompression

Ashwani K. Singal, Manoj Kathuria, Advitya Malhotra, Richard W. Goodgame, Roger D. Soloway

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Bilhemia or bile mixing with blood is a rare clinical problem. The clinical presentation is usually transient self-resolving hyperbilirubinemia, progressive and rapidly rising conjugated hyperbilirubinemia, or recurrent cholangitis. Endoscopic retrograde cholangio-pancreatography (ERCP) plays an important role in diagnosis and management. Biliary decompression with endoscopic sphincterotomy is useful in treating these patients. If not recognized and treated in time, the condition can be fatal in a significant proportion of patients. This usually occurs after blunt or penetrating hepatic trauma due to a fistulous connection between the biliary radicle and portal or hepatic venous radical. Cases have been described due to iatrogenic trauma such as liver biopsy and percutaneous biliary drainage. However, the occurrence after trans-jugular intra-hepatic porto-systemic shunt (TIPS) is very rare. We report a case of bilhemia presenting as rapidly rising bilirubin after TIPS. The patient was managed successfully with ERCP and removal of a blood clot from the common bile duct.

Original languageEnglish (US)
Pages (from-to)3681-3683
Number of pages3
JournalWorld Journal of Gastroenterology
Volume15
Issue number29
DOIs
StatePublished - Aug 7 2009

Fingerprint

Decompression
Neck
Liver
Hyperbilirubinemia
Endoscopic Sphincterotomy
Cholangitis
Wounds and Injuries
Common Bile Duct
Bilirubin
Bile
Drainage
Thrombosis
Biopsy

Keywords

  • Bilhemia
  • Biliary-venous fistula
  • Portal veinbiliary fistula
  • Trans-jugular intrahepatic shunt

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Bilhemia after trans-jugular intra-hepatic porto-systemic shunt and its management with biliary decompression. / Singal, Ashwani K.; Kathuria, Manoj; Malhotra, Advitya; Goodgame, Richard W.; Soloway, Roger D.

In: World Journal of Gastroenterology, Vol. 15, No. 29, 07.08.2009, p. 3681-3683.

Research output: Contribution to journalArticle

Singal, Ashwani K. ; Kathuria, Manoj ; Malhotra, Advitya ; Goodgame, Richard W. ; Soloway, Roger D. / Bilhemia after trans-jugular intra-hepatic porto-systemic shunt and its management with biliary decompression. In: World Journal of Gastroenterology. 2009 ; Vol. 15, No. 29. pp. 3681-3683.
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