Fatal hemobilia resulting from an iatrogenic arteriobiliary fistula as a rare complication of transjugular liver biopsy. 2008

Gerald C Gurakuqi, and Vanessa Stadlbauer, and Horst R Portugaller, and Christoph Högenauer, and Michael Trauner, and Rudolf E Stauber
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria.

Transjugular liver biopsy is an important tool for diagnosing and/or staging of advanced liver disease. This procedure is considered safe even in the presence of severe coagulopathy, although rare fatal complications have been described. We herein report the first case of fatal hemobilia after transjugular liver biopsy. A patient with alcoholic liver cirrhosis developed hematemesis 1 day after transjugular liver biopsy. Upper gastrointestinal endoscopy revealed bleeding from the papilla of Vater. Despite early intervention by angiography and embolization of an arteriobiliary fistula, the patient deteriorated and ultimately died due to multiorgan failure.

UI MeSH Term Description Entries
D008099 Liver A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances. Livers
D008104 Liver Cirrhosis, Alcoholic FIBROSIS of the hepatic parenchyma due to chronic excess ALCOHOL DRINKING. Alcoholic Cirrhosis,Hepatic Cirrhosis, Alcoholic,Alcoholic Hepatic Cirrhosis,Alcoholic Liver Cirrhosis
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D006431 Hemobilia Hemorrhage in or through the BILIARY TRACT due to trauma, inflammation, CHOLELITHIASIS, vascular disease, or neoplasms. Biliary Tract Hemorrhage,Hemorrhage, Biliary Tract,Biliary Tract Hemorrhages,Hemobilias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001164 Arteriovenous Fistula An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE. Aneurysm, Arteriovenous,Arteriovenous Aneurysm,Arteriovenous Fistulas,Fistula, Arteriovenous,Fistulas, Arteriovenous
D001658 Biliary Fistula Abnormal passage in any organ of the biliary tract or between biliary organs and other organs. Biliary Fistulas,Fistula, Biliary,Fistulas, Biliary
D001707 Biopsy, Needle Removal and examination of tissue obtained through a transdermal needle inserted into the specific region, organ, or tissue being analyzed. Aspiration Biopsy,Puncture Biopsy,Aspiration Biopsies,Biopsies, Aspiration,Biopsies, Needle,Biopsies, Puncture,Biopsy, Aspiration,Biopsy, Puncture,Needle Biopsies,Needle Biopsy,Puncture Biopsies
D017809 Fatal Outcome Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept. Fatal Outcomes,Outcome, Fatal,Outcomes, Fatal

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