{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:48:18Z","timestamp":1781527698819,"version":"3.54.1"},"reference-count":13,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,7,26]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>We present a case of haemobilia as a primary presentation for underlying cholangiocarcinoma. A man in his 50s initially presented to emergency with Quincke\u2019s triad, RUQ pain, jaundice and UGI bleeding. The initial diagnosis of haemobilia was made on endoscopic retrograde cholangiopancreatography (ERCP) on primary presentation, but the presence of blood and the recurrent clot obstruction of the biliary tract made the underlying diagnosis extremely difficult, resulting in the patient having 4 ERCP, 1 spyglass and multiple CTs and magnetic resonance cholangiopancreatography. Eventually, the patient underwent a Whipple\u2019s procedure without tissue diagnosis, confirming cholangiocarcinoma on histopathology. This case emphasises the difficulty of diagnosis of underlying malignancy in the setting of haemobilia, the benefit of multidisciplinary meeting discussions to support significant interventions and the need to be cautious and curious when managing atypical presentations.<\/jats:p>","DOI":"10.1136\/bcr-2024-260524","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T22:31:03Z","timestamp":1724970663000},"page":"e260524","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Haemobilia as a primary presentation of cholangiocarcinoma"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8513-3711","authenticated-orcid":false,"given":"Peter","family":"Stapleton","sequence":"first","affiliation":[{"name":"The University of Sydney Discipline of Surgery, Sydney, New South Wales, Australia"},{"name":"Urology, Grampians Health, Ballarat, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngochoang","family":"Ha","sequence":"additional","affiliation":[{"name":"SA Health, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Saxon","sequence":"additional","affiliation":[{"name":"Department of Pathology, Royal Adelaide Hospital, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John-Edwin","family":"Thomson","sequence":"additional","affiliation":[{"name":"Hepato-pancreato-biliary Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"2025082704032079000_17.8.e260524.1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.livres.2018.09.007","article-title":"Hemobilia: Etiology, diagnosis, and treatment","volume":"2","author":"Berry","year":"2018","journal-title":"Liver Res"},{"key":"2025082704032079000_17.8.e260524.2","doi-asserted-by":"crossref","unstructured":"Bates D . 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