Hemoperitoneum after percutaneous liver biopsy. Video-laparoscopic management.
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.
Vettoretto
Nereo
N
UO. di Chirurgia Generale e Vascolare, Azienda Ospedaliera "Mellino Mellini", P.O. Chiari, BS. nereovet@hotmail.com
Romessis
Mattheos
M
Di Gaspare
Annunzio
A
Pettinato
Giovanna
G
Arru
Luca
L
Giovanetti
Maurizio
M
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