, Volume 58, Issue 3, pp 630-633
Date: 08 Jun 2012

Hemobilia from Transjugular Liver Biopsy Resulting in Gallbladder Rupture

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Case Presentation and Evolution

A 69-year-old woman with progressively worsening liver function underwent transjugular liver biopsy in order to find a possible treatable etiology. Her liver disease was characterized by diuretic-controlled ascites and portal hypertension without the presence of esophago-gastric varices, jaundice, or encephalopathy. Prior evaluation for the etiology of the worsening liver function had only yielded a positive antinuclear antibody test. She also had a history of hypertension-induced end-stage renal disease requiring dialysis over the previous decade (peritoneal dialysis for the first 8 years and hemodialysis for the previous 2 years).

Shortly after the biopsy (for which the access was gained through the right internal jugular vein), she developed severe epigastric pain, nausea, and vomiting of 500 cc of blood-tinged material with the appearance of coffee grounds. Upon further assessment, she was noted to be hypertensive with systolic blood pressures in the 2 ...