TITLE:
Hemobilia: Etiological Diversity and Endovascular Management—A Series of Six Cases
AUTHORS:
Soukayna Allali, Salih Abdesslam, Oumaima El Abed, Asmae Lamine, Maria Lahlali, Rachid El Jim, Amine El Mekkaoui, Nada Lahmidani, Mounia El Yousfi, Dafr-Allah Benajah, Mohammed El Abkari, Sidi Adil Ibrahimi, Hakima Abid
KEYWORDS:
Hemobilia, Gastrointestinal Bleeding, Arterial Pseudoaneurysm, Transcatheter Arterial Embolization, Interventional Angiography
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.16 No.3,
March
13,
2026
ABSTRACT: Hemobilia is a rare but potentially life-threatening cause of gastrointestinal bleeding, resulting from an abnormal communication between a vessel of the splanchnic circulation and the biliary tree. Its diagnosis is often challenging due to polymorphic clinical presentations. We report a retrospective, single-center study conducted in the Department of Hepato-Gastroenterology at Hassan II University Hospital in Fez between March 2022 and March 2026, including six patients managed for confirmed hemobilia. Gastrointestinal bleeding was the main presenting feature in all patients, sometimes associated with jaundice or biliary pain. Etiologies were predominantly post-surgical iatrogenic causes, particularly following cholecystectomy, as well as tumoral causes. Endoscopy allowed suspicion of the diagnosis in several cases, while computed tomography angiography and selective arteriography identified the vascular source of bleeding. Transcatheter arterial embolization achieved effective bleeding control in the majority of cases, avoiding the need for surgical management. This series highlights the diversity of mechanisms and clinical presentations of hemobilia and confirms the central role of interventional angiography in its modern management.