Superior Epigastric Artery Haemorrhage Following Percutaneous Liver Biopsy
G Aberdein, S Chokka, KK Lau
Hong Kong J Radiol 2017;20:e18-20
DOI: 10.12809/hkjr1716814
The use of a subcostal (or sub-xiphisternal) approach to biopsy of the left lobe of the liver is less painful and causes lower rates of pneumothorax and damage to intercostal vessels and nerves, although necessitating a steeper needle angle and deeper hepatic penetration. We report a case of superior epigastric artery haemorrhage following percutaneous liver biopsy through this approach. Emergency ligation of the left superior epigastric artery achieved haemostasis. Multi-phase computed tomography angiography may aid the detection of small bleeding from the artery. The presence of a midline extraperitoneal haemorrhage should raise suspicion of superior epigastric artery injury.
Authors’ affiliations:
G Aberdein: Department of Radiology, Alfred Health, Richmond, Australia
S Chokka, KK Lau: Department of Radiology, Monash Medical Centre, Melbourne, Australia
中文摘要
經皮肝活檢後出現腹壁上動脈出血
G Aberdein, S Chokka, KK Lau
使用肋下（或胸骨底部）入路活檢肝左葉痛楚較少、氣胸率較低、肋間血管和神經損傷較少，但需要更陡的入針角度和穿透更深的肝組織。本文報告一例使用此方法經皮肝活檢後出現腹壁上動脈出血。緊急結紮左上腹動脈後成功止血。多相電腦斷層掃描血管造影有助檢測動脈小出血。中線腹膜外出血應懷疑有腹壁上動脈損傷。