Fatal hemorrhage from an arterio-portal-peritoneal fistula after percutaneous liver biopsy.
Exsanguinating hemorrhage complicated a percutaneous needle biopsy in a 64-yr-old woman with a probable collagen vascular disease. Angiography performed before Gelfoam embolization demonstrated a hepatic arterio-portal venous-peritoneal fistula, a lesion not previously described, to be a cause of the hemorrhage. Although surgery remains the treatment of choice, the role of selective hepatic arteriography and Gelfoam embolization in patients with serious hemorrhage who are poor surgical risks needs evaluation.
Korula
J
J
Department of Medicine, University of Southern California School of Medicine, Los Angeles.
Fried
J
J
Weissman
M
M
Greaney
G
G
Liew
C T
CT
Finck
E
E
D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D001707:Biopsy, Needle / Q000009:adverse effects*; D005260:Female; D005402:Fistula / Q000209:etiology*; D006470:Hemorrhage / Q000209:etiology*; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000473:pathology*; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000209:etiology*; D011169:Portal Vein / Q000000981:diagnostic imaging; D011859:Radiography