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Updated: Mar 10, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Unexplained gastrointestinal bleed due to arteriobiliary fistula after percutaneous liver biopsy
John Smirniotopoulos1, Paul Barone1, Marc Schiffman1
1New York Presbyterian Hospital/Weill Cornell Medicine, Department of Interventional Radiology, 525 East 68th Street, Payson Pavilion 5, New York, NY 10065, United States.
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.
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