Non-operative management of haemobilia

Background: The aim was to evaluate a non-operative approach to the managem ent of haemobilia. Methods: This was a retrospective analysis of patients presenting over 10 y ears with haemobilia. All patients had upper gastrointestinal endoscopy, ab dominal ultrasonography and digital subtraction angiography. Superselective coil and/or Gelfoam embolization was done as close as possible to the blee ding site. Completion angiography was performed routinely to confirm adequa te embolization. Results: There were 23 patients with liver trauma and six with inflammatory conditions. All patients required resuscitation with fluids and blood tran sfusion, and had the haemobilia controlled successfully by angiographic emb olization. There was one death from fulminant hepatic sepsis. Conclusion: This series attests to the efficacy of a non-operative approach to haemobilia using radiological diagnosis and intervention.