Intrahepatic hematoma after aspiration liver biopsy. A prospective randomized trial using two different needles

The purpose of this study was twofold: (1) to determine the incidence of intrahepatic hematoma after liver biopsy by the aspiration technique and (2) to compare the incidence of hematoma after biopsy with a needle of 1.6 mm vs 1.9 mm OD. Fifty-one patients were randomly assigned to be biopsied with the smaller needle and 46 with the larger. Hematomas, diagnosed by development of characteristic transient defects on liver scans done shortly after biopsy, occurred in two (4%) of those biopsied with the smaller needle and in none of those biopsied with the larger. This difference is not statistically significant. Neither patient who developed a hematoma had changes in vital signs, CBC, or serum alkaline phosphatase. One had a fivefold rise in SGOT; n the other, the SGOT remained normal. If these results are considered with those of other prospective trials of similar design, the overall incidence of intrahepatic hematoma after aspiration biopsy may be estimated to be 2.3% when needles of 1.6-2.0 mm (OD) are used. Many of these go undetected because, justifiably, scans are not routinely done shortly after biopsies.