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BMJ Case Reports 2017; doi:10.1136/bcr-2016-218930
  • Unusual presentation of more common disease/injury
  • CASE REPORT

Venobiliary fistula with haemobilia: a rare complication of percutaneous liver biopsy

  1. Renee Williams3
  1. 1Internal Medicine, New York University Langone Medical Center/Lutheran Medical Center, Brooklyn, New York, USA
  2. 2Pulmonary and Critical Care, Augusta University, Augusta, Georgia, USA
  3. 3Gastroenterology, New York University Langone Medical Center/Bellevue Hospital Center, New York , New York, USA
  1. Correspondence to Dr Rotimi Ayoola, rotimi.ayoola{at}nyumc.org
  • Accepted 16 June 2017
  • Published 14 July 2017

Summary

We describe a case of a 36-year-old man with a history of chronic hepatitis C who presented with abdominal pain 3 days after undergoing a percutaneous ultrasound-guided liver biopsy. Initial investigations revealed a venobiliary fistula with haemobilia and obstructive jaundice with direct bilirubin peaking at 9.2 mg/dL. He underwent an endoscopic retrograde cholangiopancreatography with sphincterotomy and stent placement, bilirubin decreased to 3.7 mg/dL, and the patient was discharged. The patient returned with recurrent abdominal pain and upper gastrointestinal bleeding with haemoglobin of 8.6 g/dL, requiring multiple transfusions. He underwent transcatheter arterial embolisation but continued bleeding. Radiofrequency ablation was pursued and was able to achieve haemostasis. The patient was discharged. The patient returned again with a fever of 39.2 °C and was found to have a large right hepatic lobe abscess. The patient underwent abscess drainage with drain placement and was treated with antibiotics for 6 weeks. He followed up in the clinic with resolution of symptoms and infection.

Footnotes

  • Contributors Case study written up by RA and PJ, and supervised and edited by RW. RA was clinically involved in the case.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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