Hemobilia Following Percutaneous Needle Biopsy of the Liver

Abstract

MASSIVE bleeding into the bile ducts is rare. Percutaneous needle biopsy of the liver is a commonly employed medical procedure. It is unlikely that gastrointestinal hemorrhage as a complication of liver biopsy has not occurred or been recognized prior to the episode described in this paper, yet no reported similar incident could be found. Hemobilia is a term first used in 1946 by Sandblom¹ to describe bleeding into the bile ducts. It has gained wide usage by those reporting gastrointestinal hemorrhage from within the liver and its extrahepatic ducts. First described by Owens² in 1848, it has been rarely reported until the last decade. The literature now has many case reports most often describing blunt trauma to the liver with delayed bleeding.^1-11 Reports of penetrating trauma,¹⁰.22-caliber gunshot wounds,^12,13 calculous erosion of vessel and bile ducts,^14,15 abscess necrosis creating biliary vascular fistulae,¹⁶