Haematochezia in Crohn's disease caused by late-onset haemobilia following percutaneous liver biopsy.
The case of a patient with Crohn's disease and who presented 4 days after a percutaneous liver biopsy with haematochezia suggestive of an exacerbation of his inflammatory bowel disease is described. Subsequent abdominal ultrasonography revealed free fluid in the peritoneal cavity and around the gallbladder. Haemobilia was suspected. Selective hepatic arteriography demonstrated a fistula between the hepatic artery and the portal venous system, with the presence of a hepatic artery pseudoaneurysm. Bleeding was stopped by arterial embolisation using titanium microcoils. Haemobilia is a very rare complication of percutaneous liver biopsy, but it should not be overlooked as a potential late-onset cause of rectal bleeding following this procedure. Selective hepatic arterial embolisation is an effective and safe treatment for this serious complication.
Hodgson
Ruth S
RS
Gastroenterology Unit, Division of Medicine A, Imperial College School of Medicine, Hammersmith Hospital, London, UK.
Taylor-Robinson
Simon D
SD
Jackson
James E
JE
D000328:Adult; D001164:Arteriovenous Fistula / Q000209:etiology; D001706:Biopsy / Q000009:adverse effects; D003424:Crohn Disease / Q000150:complications* / Q000473:pathology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000473:pathology; D006431:Hemobilia / Q000150:complications* / Q000473:pathology; D006499:Hepatic Artery / Q000002:abnormalities; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D011169:Portal Vein / Q000002:abnormalities