Acute Arteriobiliary Fistula Emergent Long after Biliary Drainage and Radioembolization

Abstract

Various causes of hemobilia have been described in the literature, majority being iatrogenic. Other different pathologies such as inflammation and tumors also have been described. A 55-year-old male, who had a history of obstructive jaundice caused by a 4-cm liver mass treated with external-internal biliary drainage and transarterial radioembolization 6 months back, presented with acute hemobilia. Computed tomography demonstrated widespread radionecrosis of the right lobe and extravasation of intravascular contrast from right hepatic artery into common bile duct. Verified on angiography, the arteriobiliary fistula was managed with coil embolization.

Keywords

• late-onset hemobilia
• arteriobiliary fistula
• arterial injury
• radionecrosis