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Case Reports
. 2016 Sep 28;3(4):e132.
doi: 10.14309/crj.2016.105. eCollection 2016 Aug.

Hemobilia from Biliary Angiodysplasia Diagnosed with Cholangioscopy

Kap Sum Foong  1 , Ashley Lee  2 , Shaismy Kudakachira  1 , Hemchand Ramberan  3
Affiliations
Case Reports

Hemobilia from Biliary Angiodysplasia Diagnosed with Cholangioscopy

Kap Sum Foong et al. ACG Case Rep J. .

Abstract

Biliary angiodysplasia is extremely rare. Our background search revealed only a few case reports in the English literature. We present a case of angiodysplasia of the proximal common bile duct in a patient with subacute upper gastrointestinal bleeding and symptomatic anemia. A standard esophagogastroduodenoscopy with subsequent dedicated duodenoscopy revealed blood-stained bile draining from the major ampulla orifice. A contrast-enhanced magnetic resonance cholangiopancreatography was unrevealing for any pancreaticobiliary pathology. The patient subsequently underwent an endoscopic retrograde cholangiopancreatography and SpyGlass® cholangioscopy, which demonstrated intermittent bleeding from angiodysplasia in the proximal common bile duct.

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Figures

Figure 1
Figure 1
(A) Blood-stained bile pooling near to the major ampulla orifice. (B) Duodenoscopy with en-face view showed hemobilia with dark reddish blood emanating from the major ampulla orifice.
Figure 2
Figure 2
(A) SpyGlass® cholangioscopy revealed ectatic blood vessels in the proximal CBD after thorough irrigation and suction. (B and C) Close up views of the angiodysplasia.
See this image and copyright information in PMC

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