Arterioportal fistula and hemobilia with associated acute cholecystitis: a complication of percutaneous liver biopsy.
Complications attributable to percutaneous liver biopsy, including hemobilia and arterioportal fistula, are uncommon. In this report, we present the case of a patient who underwent percutaneous liver biopsy and, as a consequence of this procedure, developed an arterioportal fistula and hemobilia with associated acute cholecystitis. The diagnosis of hemobilia was possible with abdominal ultrasound and upper endoscopy, but the patient required cholecystectomy. Hepatic angiography was performed, demonstrating the arterioportal fistula and hemobilia. Transcatheter embolization occluded the fistula, resolving the hemobilia. We recommend ultrasound and upper endoscopy as initial diagnostic procedures, but angiography and selective embolization must not be delayed if arterioportal fistula and/or hemobilia is suspected since these measures may help to prevent further complications.
Cacho
G
G
Department of Gastroenterology, Hospital Puerta de Hierro, Madrid, Spain.
Abreu
L
L
Calleja
J L
JL
Prados
E
E
Albillos
A
A
Chantar
C
C
Perez Picouto
J L
JL
Escartín
P
P
D000208:Acute Disease; D000368:Aged; D001164:Arteriovenous Fistula / Q000209:etiology*; D001707:Biopsy, Needle / Q000009:adverse effects*; D002764:Cholecystitis / Q000209:etiology*; D006431:Hemobilia / Q000209:etiology*; D006499:Hepatic Artery; D006801:Humans; D008297:Male; D011169:Portal Vein