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Haemobilia 2 weeks after a low thoracic stab wound.

BACKGROUND
Haemobilia occurs in only 1.2-5% of patients with accidental liver trauma. We describe an unusual case 2 weeks after penetrating thoracic injury.


CASE OUTLINE
A 27-year-old man underwent laparotomy for hepatic bleeding after a low thoracic stab wound. Two weeks later rectal blood loss occurred. CT scan and angiography revealed intrahepatic contrast extravasation at the previous stab wound site. Coils were successfully placed into two branches of the right hepatic artery.


DISCUSSION
Haemobilia should be considered in patients presenting with gastrointestinal blood loss after liver injury. It is diagnosed with angiography and preferably treated by embolisation.