title: Unexplained gastrointestinal bleed due to arteriobiliary fistula after percutaneous liver biopsy.
abstract: We represent a case of a 54-year-old male who presented to the emergency department with right upper quadrant abdominal pain and melena three weeks after percutaneous liver biopsy. He was found to have anemia secondary to an upper gastrointestinal hemorrhage, unresponsive to multiple blood transfusions. Angiography later revealed an arteriobiliary fistula with contrast extravasation entering the duodenum. The fistula was successfully embolized and the patient was discharged without complication. This report demonstrates the importance in considering a vascular intrahepatic fistula in patients with right upper quadrant abdominal pain after remote liver biopsy.
authors.affiliation: New York Presbyterian Hospital/Weill Cornell Medicine, Department of Interventional Radiology, 525 East 68th Street, Payson Pavilion 5, New York, NY 10065, United States. Electronic address: j.smirn@gmail.com.
authors.forename: John
authors.initials: J
authors.lastname: Smirniotopoulos
authors.affiliation: New York Presbyterian Hospital/Weill Cornell Medicine, Department of Interventional Radiology, 525 East 68th Street, Payson Pavilion 5, New York, NY 10065, United States.
authors.forename: Paul
authors.initials: P
authors.lastname: Barone
authors.affiliation: New York Presbyterian Hospital/Weill Cornell Medicine, Department of Interventional Radiology, 525 East 68th Street, Payson Pavilion 5, New York, NY 10065, United States.
authors.forename: Marc
authors.initials: M
authors.lastname: Schiffman
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000792:Angiography; D001707:Biopsy, Needle / Q000009:adverse effects*; D004621:Embolization, Therapeutic; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006431:Hemobilia / Q000209:etiology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016157:Vascular Fistula / Q000209:etiology*
keywords: Gastrointestinal hemorrhage; Intrahepatic arteriobiliary fistula; Percutaneous liver biopsy