Delayed fatal hemorrhage from pseudoaneurysm of the hepatic artery after percutaneous liver biopsy

Hemorrhage is the most common serious complication of percutaneous liver bi opsy. Liver biopsy is usually done in an outpatient setting because most si gnificant hemorrhage is evident within a few hours after biopsy. Delayed he morrhage occurs much less frequently but carries a much higher mortality. W e present a 41-yr-old man with chronic hepatitis C who underwent a percutan eous liver biopsy uneventfully but was found to have a pseudoaneurysm of th e hepatic artery 5 days later. Shortly after admission, the patient experie nced bleeding into the liver from the pseudoaneurysm, which was controlled initially by angiographic embolization. However, recurrent bleeding could n ot be controlled by repeat angiography and surgical intervention, and the p atient expired. The diagnosis and management of pseudoaneurysm of the hepat ic artery complicating liver biopsy is reviewed. (Am J Gastroenterol 2001;9 6:233-237. (C) 2001 by Am. Coll. of Gastroenterology).