Hemobilia should be considered in all cases of blunt or penetrating trauma to the liver, no matter how trivial it may appear, whenever right upper quadrant pain and a persistently elevated alkaline phosphatase level give evidence of an otherwise unexplained biliary obstruction or hepatic mass lesion. Jaundice and evident gastrointestinal bleeding may not appear until late in the course. All available diagnostic modalities should be utilized to confirm the diagnosis, and angiography should be done early whenever the diagnosis is seriously considered. If hemobilia is documented at angiography, an attempt at selective embolization should always be made. Selective angiographic embolization may well save the patient an operative procedure, and appears to be an acceptable method of primary treatment of this condition. A case of hemobilia from penetrating abdominal trauma with successful operative treatment is described.
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