Traumatic Hemobilia Treated by Massive Liver Resection

Gastrointestinal bleeding caused by bleeding into the bile ducts from an injured liver was termed traumatic hemobilia by Sandblom in 1948.⁶ The clinical manifestations of this syndrome are characterized by (1) previous liver or abdominal injury, (2) severe pain in the upper abdomen, anterior chest, or right shoulder, and (3) gastrointestinal bleeding of either minor or major proportions. The treatment of this problem has consisted of a wide spectrum of methods including observation, drainage, packing with various materials, cholecystostomy, T-tube drainage, hepatic artery ligation, and direct ligation of the bleeding vessels in the liver abscess cavity. Most of these methods with the exception of the latter two are indirect and have been associated with either death of the patient or recovery that could be associated with therapy only with difficulty. With the knowledge of the ineffectiveness of most of these methods of therapy it seems logical that the most