[Arterial embolization of an arteriovenous fistula with hemobilia after blind liver puncture].
Five days after percutaneous liver biopsy we observed in a 42-year-old man with alcoholic liver cirrhosis severe hemobilia requiring transfusions of packed red cells. By means of super-selective arterial embolization, using gelfoam, the bleeding source, an av-fistula, was successfully occluded. Iatrogenic hemobilia, although seen after percutaneous liver biopsy only in app. 0.005% of the cases, is today the most important cause of biliary bleeding, mainly as a complication (app. 3% of the cases) of the widespread use of interventional procedures of the biliary tree (e.g. PTCD). Therapeutically arterial embolization should be considered first if possible.
Ormann
W
W
Medizinische Klinik I, Städtische Kliniken Kassel.
Starck
E
E
Pausch
J
J
D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D001707:Biopsy, Needle / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006431:Hemobilia / Q000000981:diagnostic imaging / Q000628:therapy*; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography
Arterielle Embolisation einer arterio-venösen Fistel mit Hämobilie nach Leberblindpunktion.