A CASE OF SO-CALLED IDIOPATHIC HEMOBILIA

A 67-year-old man was admitted with obstractive jaundice. Percutaneous transhepatic cholangiogram showed clots in the CBD, but we mistook them for biliary stones at first. As these clots disappeared by the cholangiography 4 days later, we could diagnose this case as hemobilia. After bleeding had stopped with biliary drainage, percutaneous transhepatic cholangioscopy (PTCS) and angiography were performed, but no bleeding lesion was revealed. He was discharged after benign course 2 months later. Hemobilia is a rare status, especially there are few cases of unknown origin. This case of idoopathic hemobilia is reported with reference to the literature. Diagnostic value of PTCS in hemobilia is also mentioned.