Case: 224

Hemobilia After Liver Biopsy

Show  

History: 53 yo male with history of liver transplant. RUQ pain after liver biopsy. Evaluate for bleed.
Solution: The findings here are a little subtle, but definitely something you should be on the lookout for. Hemobilia is seen in less than 0.1% of patients after a liver biopsy, but can be a serious complication and should be evaluated for in the symptomatic patient. In this case, on the non-contrast images, you can see high attenuation material replacing the bile you would normally expect to see in the CBD. This is associated with biliary ductal dilatation and no evidence of other bleeding. An ERCP was performed and the clot within the CBD was removed. Patient did well afterwards.




Ultrasound Images

Questions

The most common severe complication after a liver biopsy is:
  • Hemorrhage
  • Pain
  • Collateral damage
  • Death
  • Infection
Death can be expected in approximately 0.1% of patients having a liver biopsy.
True
What is the most likely complication that has occurred in this patient?
Hemobilia.