Best investigation of bilhemia is

Bilhemia It is an extremely rare condition Bile flows into the blood stream either through the hepatic veins or poal vein branches Etiology High intra biliary pressure, exceeding that of venous system (CBD stone). Gallstones eroding into the poal vein. Accidental or iotrogenic trauma Clinical features Rapidly increasing jaundice, marked direct hyperbilirubinemia The condition can be fatal secondary to embolization of large amounts of bile into the lungs Most often, bile flow is low and the Fistulas Spontaneously closes Diagnosis ERCP is investigation of choice (Diagnostic and therapeutic) Treatment Treatment is directed at lowering intra biliary pressure either through stents or sphincterectomy Ref : Sabiston 20th edition Pgno : 1473-1474