Prospective study of the incidence of ultrasound-detected intrahepatic and subcapsular hematomas in patients randomized to 6 or 24 hours of bed rest after percutaneous liver biopsy

Gy, Minuk; Sutherland, Lloyd R.; Wiseman, David; MacDonald, F.R.; Ding, Defang

doi:10.1016/0016-5085(87)90119-3

Cited by 95 publications

(48 citation statements)

References 11 publications

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“…The major complication and main cause of postprocedural death is intraperitoneal bleeding. Substantial hemorrhage is described in 0.35%-0.5% of all liver biopsies, and subclinical bleeding occurs in up to 23% of patients (3,4,(7)(8)(9). In our study, none of the patients developed clinically important hemorrhage, a finding that may be attributed to our strict adherence to preestablished coagulation criteria, coupled with the experience of our operators.…”

Section: Discussionsupporting

confidence: 53%

Focal Hepatic Lesions: US-guided Biopsy—Lessons from Review of Cytologic and Pathologic Examination Results

Appelbaum

Kane²,

Kruskal³

et al. 2009

Radiology

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Purpose:To retrospectively assess factors affecting the success of ultrasonographically (US)-guided core liver biopsy of focal lesions on the basis of experience when both cytologic and pathologic examination results were available. Materials and Methods:This HIPAA-compliant retrospective study was granted an exemption from the institutional review board. Results:Biopsy specimens were diagnostic in 205 cases (98.6%) and were nondiagnostic in three cases (1.4%); 85.9% of the lesions were malignant. There was a single lesion in 89 patients (42.8%), and there were multiple lesions in 119 patients (57.2%). One biopsy pass was sufficient in 58 patients (27.9%); two passes were sufficient in 75 patients (36.1%); and three, four, five, and six passes were sufficient in 51 (24.5%), 17 (8.2%), five (2.4%), and two (1.0%) patients, respectively. There was no relationship between lesion size or location and the number of passes, according to the Pearson correlation and 2 test (P ϭ .16 and P ϭ .22, respectively). On average, 1.9 passes were required for metastatic lesions, versus 2.8 for nonmetastatic lesions (P Ͻ .001, Wilcoxon test). Cytologic and histopathologic findings were discordant in 25 cases (12.0%). Conclusion:The size and location of liver lesions sampled for biopsy do not influence the number of passes needed, while metastatic lesions require fewer passes. Without the on-site cytologic examination service, a predetermined number of three passes would be diagnostic in almost 90% of all cases.

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Section: Discussionsupporting

confidence: 53%

Focal Hepatic Lesions: US-guided Biopsy—Lessons from Review of Cytologic and Pathologic Examination Results

Appelbaum

Kane²,

Kruskal³

et al. 2009

Radiology

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“…(7,10) Outside of frank trauma to adjacent organs or severe bleeding, the mechanism of postbiopsy pain is uncertain and the biopsy site pain is likely to be a nociceptive pain that originates from the skin, the nociceptive innervated liver capsule, or both and high anxiety levels have been shown to exacerbate acute postoperative pain. (10,11,12) The right-shoulder pain after liver biopsy is well known but has never been fully characterized. In other words, pain in the right shoulder begins, reaches its peak, and subsides together with the biopsy site pain.…”

Section: Painmentioning

confidence: 99%

“…These hematomas are generally small and are not associated with significant hemodynamic compromise. (11) The initial indications of bleeding are right upper quadrant abdominal pain that require analgesia and changes in vital signs with drop in blood pressure and rise in pulse rate. (19) Most cases of fatal hemorrhage especially free intraperitoneal resulted from perforation of portal or hepatic veins or aberrant arteries.…”

Section: Bleedingmentioning

confidence: 99%

Complications of Liver Biopsy

Alghamdi¹

2011

Liver Biopsy

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“…If intraperitoneal haemorrhage is suspected the patient should be resuscitated, have imaging studies (CT or ultrasound) to confirm this and if resuscitation fails then angiography and embolisation or less commonly surgery to halt bleeding. Intrahepatic or subcapsular haematomas tend to be asymptomatic (Raines, Van Heertum and Johnson 1974) and occurs in about 23% of patients (Minuk, Sutherland, Wiseman, MacDonald and Ding 1987). However, large haematomas can present with pain or signs of intravascular depletion i.e hypotension and tachycardia (Van Thiel, et al 1993).…”

Section: Bleedingmentioning

confidence: 99%