Liver biopsy can be performed percutaneously, or via a transjugular approach. Transjugular liver biopsy (TJLB) is usually used in patients who are suffering from severe coagulation disorders (prolonged prothrombin time or low platelets), ascites, severe obesity, or failure of a previous non-targeted percutaneous liver biopsy. In TJLB, the biopsy needle is inserted into the liver parenchyma via the hepatic vein, avoiding transgression of the hepatic capsule and peritoneum. Unlike a percutaneous biopsy, a transjugular approach reduces the risk of bleeding as any bleeding from the biopsy site should be returned into the venous system. It is a safe, well-tolerated procedure, with a major complication rate of less than 0.6%. This case report describes the rare occurrence of a severe intraperitoneal haemorrhage post-TJLB, and describes and discusses the technique, complication profile, and learning points from this complication.

Background and ObjectivesPatients are recruited to act as educators, sharing experiences of their illness to facilitate active student learning. At our institution, cancer patient educators have been recruited to participate in a weekly teaching session for students. Our study was designed to assess the benefits that partaking in medical education confers on patients who were treated for cancer, as well as explore their motivations for becoming educators and how we can improve their experiences in the future. MethodologyOur study used a qualitative exploratory research design, with four current patient educators being selected to participate. The interviews were conducted virtually and were designed to allow patients the opportunity to provide a rich narrative of their experiences. Their accounts were transcribed using built-in transcription software and analysed using interpretative phenomenological analysis (IPA). IPA is an in-depth analytical method used to identify common themes between patients' experiences and explore why these themes exist. ResultsFour superordinate themes, each with its subthemes were identified following analysis of patient transcripts: the perceived success of the session (relationship between patient educator and facilitator, willingness of students to participate, organisation and planning of the session), motivations for becoming a patient educator (wanting to give something back, personal attributes making them suitable for the role and improving experiences of future patients), perceived benefits of engaging in medical education (improvement in mental health and engaging with medical students) and suggested improvements for the session (logistics and recruitment). ConclusionsBeing a cancer patient educator offers significant benefits for patients' well-being, particularly in mental health. Cancer patient educators are motivated by the need to give something back to the staff and institution where they were treated. The educators also referred to improving care for future patients by educating students about negative experiences they encountered and how these could have been avoided. Finally, educators suggested improvements for future sessions by addressing the length of the sessions and having a formal recruitment process.