title: Hemoperitoneum after percutaneous liver biopsy. Video-laparoscopic management.
abstract: BACKGROUND
  Percutaneous liver biopsy is a safe procedure, with a low rate of major complications. Among these massive hemoperitoneum is the most life threatening, and its management sometimes leads to an emergency invasive surgical approach.
  
  
  RESULTS
  The following case highlights the possible role of laparoscopy in diagnosis and treatment of this condition. In this patient a significant intraperitoneal bleeding developed from a liver lesion 48 hours after needle-biopsy. Video-laparoscopic exploration evidenced a grade III laceration of the right lobe, successfully managed with coagulation and apposition of an absorbable haemostatic gauze. Peritoneal toilette and multiple drains completed the procedure. No surgical complications developed and the patient was discharged on 5th post-operative day.
  
  
  CONCLUSIONS
  Minimally invasive surgery has been, in this case, an adequate alternative for the treatment of this bleeding complication of liver biopsy, offering advantages in terms of low morbidity, quick recovery and satisfying cosmetic results.
  
  
  CONCLUSIONS
  Laparoscopy is gaining a prominent role in penetrating liver trauma, whenever conservative or angiographic management fails, and should be considered as the first surgical attempt especially in patients with stable hemodynamics despite active intraperitoneal bleeding.
authors.affiliation: UO. di Chirurgia Generale e Vascolare, Azienda Ospedaliera "Mellino Mellini", P.O. Chiari, BS. nereovet@hotmail.com
authors.forename: Nereo
authors.initials: N
authors.lastname: Vettoretto
authors.forename: Mattheos
authors.initials: M
authors.lastname: Romessis
authors.forename: Annunzio
authors.initials: A
authors.lastname: Di Gaspare
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pettinato
authors.forename: Luca
authors.initials: L
authors.lastname: Arru
authors.forename: Maurizio
authors.initials: M
authors.lastname: Giovanetti
mesh_terms: D001707:Biopsy, Needle / Q000009:adverse effects*; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology* / Q000601:surgery; D006526:Hepatitis C / Q000473:pathology*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008099:Liver / Q000473:pathology*; D008875:Middle Aged; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods