Bleeding hepatico-cutaneous fistula – an unusual complication of the percutaneous liver biopsy

Introduction. An arteriovenous fistula is one of the complications that can occur during percutaneous liver biopsy (PLB). Hepatic arteriovenous fistula with chronic bleeding from the puncture site on the skin is an extremely rare complication following PLB. Case report. We present a 35-year-old woma...

Full description

Saved in:
Bibliographic Details
Main Authors: Mitrović Miroslav, Jovanović Milan, Bezmarević Mihailo, Milev Boško, Mirković Darko
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2023-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502200007M.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850234451410288640
author Mitrović Miroslav
Jovanović Milan
Bezmarević Mihailo
Milev Boško
Mirković Darko
author_facet Mitrović Miroslav
Jovanović Milan
Bezmarević Mihailo
Milev Boško
Mirković Darko
author_sort Mitrović Miroslav
collection DOAJ
description Introduction. An arteriovenous fistula is one of the complications that can occur during percutaneous liver biopsy (PLB). Hepatic arteriovenous fistula with chronic bleeding from the puncture site on the skin is an extremely rare complication following PLB. Case report. We present a 35-year-old woman with secondary anemia caused by chronic bleeding at the site of a granuloma caused by a previous liver biopsy performed 7 years ago. The patient was examined and treated for several years due to anemic syndrome. The pathological communication between the right hepatic vein, the anterior sectional branch of the portal vein, and the posterior arterial sectional branch were detected on a computed tomography scan and proven by fistulography. Due to the failed embolization, a laparotomy was performed, where a tumor mass was found in the VI and VII segment of the liver, which communicates with the skin. The tumor mass was removed by atypical resection of the VI and VII liver segments. Due to hemorrhage, reexploration was performed, where the bleeding was found from the surface of the resected liver parenchyma. The patient was released for home treatment two weeks after the last operation. Conclusion. Although PLB is a safe procedure, a complication in the form of bleeding sometimes occurs but with spontaneous cessation. In the presented patient, there was a complicated intra-hepatic arteriovenous-portal fistula with the formation of communication with the puncture site on the skin. That is the first published case of complications of this type after PLB.
format Article
id doaj-art-c6f97936853d40ca9e2d98ff0bf695d5
institution OA Journals
issn 0042-8450
2406-0720
language English
publishDate 2023-01-01
publisher Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
record_format Article
series Vojnosanitetski Pregled
spelling doaj-art-c6f97936853d40ca9e2d98ff0bf695d52025-08-20T02:02:37ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202023-01-01801828610.2298/VSP211118007M0042-84502200007MBleeding hepatico-cutaneous fistula – an unusual complication of the percutaneous liver biopsyMitrović Miroslav0Jovanović Milan1Bezmarević Mihailo2https://orcid.org/0000-0003-1938-8298Milev Boško3Mirković Darko4University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for General Surgery, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for General Surgery, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for General Surgery, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for General Surgery, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for General Surgery, Belgrade, SerbiaIntroduction. An arteriovenous fistula is one of the complications that can occur during percutaneous liver biopsy (PLB). Hepatic arteriovenous fistula with chronic bleeding from the puncture site on the skin is an extremely rare complication following PLB. Case report. We present a 35-year-old woman with secondary anemia caused by chronic bleeding at the site of a granuloma caused by a previous liver biopsy performed 7 years ago. The patient was examined and treated for several years due to anemic syndrome. The pathological communication between the right hepatic vein, the anterior sectional branch of the portal vein, and the posterior arterial sectional branch were detected on a computed tomography scan and proven by fistulography. Due to the failed embolization, a laparotomy was performed, where a tumor mass was found in the VI and VII segment of the liver, which communicates with the skin. The tumor mass was removed by atypical resection of the VI and VII liver segments. Due to hemorrhage, reexploration was performed, where the bleeding was found from the surface of the resected liver parenchyma. The patient was released for home treatment two weeks after the last operation. Conclusion. Although PLB is a safe procedure, a complication in the form of bleeding sometimes occurs but with spontaneous cessation. In the presented patient, there was a complicated intra-hepatic arteriovenous-portal fistula with the formation of communication with the puncture site on the skin. That is the first published case of complications of this type after PLB.http://www.doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502200007M.pdfbiopsy, fine-needlediagnosishemorrhageliversurgical procedures, operativevascular fistula
spellingShingle Mitrović Miroslav
Jovanović Milan
Bezmarević Mihailo
Milev Boško
Mirković Darko
Bleeding hepatico-cutaneous fistula – an unusual complication of the percutaneous liver biopsy
Vojnosanitetski Pregled
biopsy, fine-needle
diagnosis
hemorrhage
liver
surgical procedures, operative
vascular fistula
title Bleeding hepatico-cutaneous fistula – an unusual complication of the percutaneous liver biopsy
title_full Bleeding hepatico-cutaneous fistula – an unusual complication of the percutaneous liver biopsy
title_fullStr Bleeding hepatico-cutaneous fistula – an unusual complication of the percutaneous liver biopsy
title_full_unstemmed Bleeding hepatico-cutaneous fistula – an unusual complication of the percutaneous liver biopsy
title_short Bleeding hepatico-cutaneous fistula – an unusual complication of the percutaneous liver biopsy
title_sort bleeding hepatico cutaneous fistula an unusual complication of the percutaneous liver biopsy
topic biopsy, fine-needle
diagnosis
hemorrhage
liver
surgical procedures, operative
vascular fistula
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502200007M.pdf
work_keys_str_mv AT mitrovicmiroslav bleedinghepaticocutaneousfistulaanunusualcomplicationofthepercutaneousliverbiopsy
AT jovanovicmilan bleedinghepaticocutaneousfistulaanunusualcomplicationofthepercutaneousliverbiopsy
AT bezmarevicmihailo bleedinghepaticocutaneousfistulaanunusualcomplicationofthepercutaneousliverbiopsy
AT milevbosko bleedinghepaticocutaneousfistulaanunusualcomplicationofthepercutaneousliverbiopsy
AT mirkovicdarko bleedinghepaticocutaneousfistulaanunusualcomplicationofthepercutaneousliverbiopsy