A patient with obstructive jaundice due to bleeding in the common bile duct after ultrasound-guided liver biopsy

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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Published on: March 25, 2022

Muneki Igarashi1, Yoshihiro Tei, Fumiyuki Akino

  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Tokai School of Medicine, Bouseidai, Isehara, Kanagawa 259-1193, Japan. muneki@tokai-u.jp

The Tokai Journal of Experimental and Clinical Medicine
|February 15, 2011
PubMed

Insights

A liver biopsy complication led to bleeding in the gallbladder and common bile duct, causing obstructive jaundice. Endoscopic retrograde cholangiopancreatography successfully removed the bile duct hematoma.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Interventional Radiology

Background:

  • Chronic hepatitis C management often involves liver biopsy for staging and treatment guidance.
  • Ultrasound-guided liver biopsy is a common diagnostic procedure.
  • Complications, though rare, can occur following liver biopsy.

Observation:

  • A 63-year-old man undergoing interferon therapy for chronic hepatitis C developed acute right upper abdominal pain post-liver biopsy.
  • Emergency computed tomography (CT) revealed bleeding into the gallbladder and common bile duct.
  • The patient presented with obstructive jaundice attributed to a common bile duct hematoma.

Findings:

  • Endoscopic retrograde cholangiopancreatography (ERCP) confirmed a filling defect consistent with a hematoma in the common bile duct.
  • Endoscopic sphincterotomy was performed to facilitate hematoma removal.
  • Successful extraction of the bile duct hematoma was achieved.

Implications:

  • This case highlights a rare but serious complication of ultrasound-guided liver biopsy.
  • Prompt diagnosis and intervention using ERCP are crucial for managing post-biopsy biliary complications.
  • Effective management can prevent further morbidity associated with obstructive jaundice.

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