Hemobilia complicating transhepatic catheter drainage in liver transplant recipients: Management with selective embolization

Two liver transplantation patients are reported who experienced severe hemobilia following percutaneous placement of a transhepatic biliary drainage catheter. In both, hepatic angiography demonstrated the source of bleeding from a traumatic pseudoaneourysm of a right hepatic artery branch. Hemobilia in both patients was successfully treated using selective embolization techniques. Follow-up computed tomography of the liver showed no evidence of allograft necrosis or abscess formation. One patient developed an intrahepatic biliary stricture adjacent to the embolized branch artery nine months following the procedure. Hepatic artery embolization techniques are effective in the treatment of life-threatening hemobilia posttransplantation.