**Question:** Not true of hemobilia

**Core Concept:** Hemobilia refers to the passage of blood into the biliary tract due to a rupture of a blood vessel in the liver or other surrounding organs.

**Why the Correct Answer is Right:** Hemobilia is typically associated with traumatic injuries, iatrogenic causes (such as invasive procedures in the biliary tree), or arterial aneurysms (e.g., ruptured hepatic or common hepatic artery aneurysms). The correct answer is "Not true of hemobilia" because hemobilia is a relatively uncommon condition, and the options provided are not directly related to its causes or characteristics.

**Why Each Wrong Option is Incorrect:**

A. **Option A:** Hemobilia is not limited to patients with cirrhosis or liver disease. Hemobilia can occur in healthy individuals as well.

B. **Option B:** Hemobilia is not confined to cholangitis (infection of the bile ducts). Hemobilia can present with varied clinical manifestations depending on the underlying cause.

C. **Option C:** Hemobilia is not exclusively caused by choledocholithiasis (gallstones in the common bile duct). Hemobilia can result from various causes, including trauma, iatrogenic procedures, and arterial aneurysms.

D. **Option D:** Hemobilia is not limited to patients with gallbladder disorders. Hemobilia can occur in patients with liver or pancreatic injuries, as well as arterial aneurysms.

**Clinical Pearl / High-Yield Fact:** Hemobilia is a clinical entity that should be considered in the differential diagnosis of patients with acute abdominal pain, cholestasis (jaundice), or cholangitis after blunt or penetrating trauma, iatrogenic procedures, or arterial aneurysms. It is essential to differentiate hemobilia from other causes of biliary obstruction, as appropriate management strategies differ.