Hemobilia and pancreatitis as complications of a percutaneous transhepatic cholangiogram

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Abstract
Percutaneous transhepatic cholangiography (PTC) was performed on a 23-year-old male because of an atypical progression of hepatitis B antigen-negative hepatitis. No bile duct was entered and the procedure was uneventful. However, celiac angiography the day following PTC revealed abnormal liver vessels in the target area and the patient developed hemobilia and clinical pancreatitis, causing common duct obstruction. Symptomatology persisted until celiotomy 32 days after PTC. Clots were found obstructing the common bile duct. This case is presented both because of the unusual complications of PTC and the unusual angiographic abnormalities. It is suggested that PTC be reserved for the evaluation of patients when there is a specific indication for the procedure either to differentiate cholestatic jaundice from extrahepatic jaundice or to localize a site of obstruction before surgical intervention.

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