Intrahepatic Hematoma and Haemobilia after Percutaneous Liver Biopsy: A Clinical Case Report

G. Sarafiloski, Mimi R. Marinova, P. Tonchev
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Abstract

Summary Assessing the severity of liver disease and predict the response to treatment in clinical practice requires the determination of the degree of inflammation progression and liver fibrosis. Percutaneous liver biopsy is the gold standard for grading and staging liver diseases. Complications are more common in the presence of vascular liver lesions, dilation of the bile ducts, ascites, or whether examination has been performed by less experienced physicians. Bleeding after liver biopsy is considered the most common cause of severe complications. Bleeding usually presents as a subcapsular or parenchymal hematoma, free intraperitoneal hemorrhage, hemobilia, or, rarely, hemothorax. The rarest of hemorrhagic complications is hemobilia, a term used to describe bleeding in the bile ducts. Hemobilia is usually suspected when there is a drop in hemoglobin after the procedure, pain in the upper right quadrant of the abdomen, hyperbilirubinemia, and unexplained gastrointestinal bleeding. The clinical manifestations range from chronic anemia to rapid, massive bleeding with hematemesis and/or melena.
经皮肝活检后肝内血肿和胆血:1例临床报告
在临床实践中,评估肝病的严重程度并预测对治疗的反应需要确定炎症进展程度和肝纤维化程度。经皮肝活检是肝脏疾病分级和分期的金标准。并发症在存在血管性肝脏病变、胆管扩张、腹水或由经验不足的医生进行检查时更为常见。肝活检后出血被认为是严重并发症的最常见原因。出血通常表现为包膜下或实质血肿、游离性腹膜内出血、胆道出血,或罕见的血胸。最罕见的出血性并发症是胆道出血,这个术语用来描述胆管出血。当术后出现血红蛋白下降、腹部右上象限疼痛、高胆红素血症和不明原因的胃肠道出血时,通常怀疑胆道出血。临床表现从慢性贫血到快速大出血伴呕血和/或黑黑。
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