Plugged liver biopsy in patients with impaired coagulation

Histology is of paramount importance in the investigation of hepatic disease but conventional percutaneous liver biopsy is contraindicated when coagulation is significantly impaired. We have used a modified percutaneous approach with plugging of the needle track in 100 patients with vitamin K-resistant prolongation of prothrombin time up to 12 sec above control values or platelet counts as low as 20 X 10(9)/liter. All were successful, and there were no serious complications. The technique is straightforward and is a feasible alternative to the more complex transvenous approach.