title: Fatal haemorrhage from an ultrasound guided fine needle aspiration of the liver in a patient with primary hepatocellular carcinoma: case report.
abstract: A case of fatal haemorrhage is reported among 72 ultrasound (US) guided percutaneous fine-needle aspiration liver biopsies (FNAB) performed in the gastro- intestinal unit of Medicine Department in a tertiary hospital. The patient had primary hepatocellular carcinoma (PHCC) with advanced hepatic cirrhosis. Death was due to bleeding from liver nodule resulting in intra-peritoneal haemorrhage. Pre-procedure laboratory tests did not reveal the existence of major bleeding disorders in the patient. This event is our first experience, but colour flow Doppler ultrasound guidance has been reported to prevent its occurrence. The use of FNAB for the diagnosis of PHCC should therefore be guided with colour flow Doppler ultrasound scan to prevent haemorrhage. In addition, there should be proper selection of patients for FNAB especially in areas where there are no colour flow Doppler ultrasound scans.
authors.affiliation: Department of Medicine, Obafemi Awolowo University /Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria.
authors.forename: O
authors.initials: O
authors.lastname: Adekanle
authors.forename: D A
authors.initials: DA
authors.lastname: Ndububa
authors.forename: O
authors.initials: O
authors.lastname: Ijarotimi
authors.forename: O A
authors.initials: OA
authors.lastname: Komolafe
authors.forename: E A
authors.initials: EA
authors.lastname: Omonisi
authors.forename: S O
authors.initials: SO
authors.lastname: Ojo
mesh_terms: D044963:Biopsy, Fine-Needle; D006528:Carcinoma, Hepatocellular; D017809:Fatal Outcome; D006465:Hemoperitoneum / Q000209:etiology*; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects*; D008099:Liver / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D018615:Ultrasonography, Doppler, Color