Fatal hemobilia resulting from an iatrogenic arteriobiliary fistula as a rare complication of transjugular liver biopsy

Abstract

Transjugular liver biopsy is an important tool for diagnosing and/or staging of advanced liver disease. This procedure is considered safe even in the presence of severe coagulopathy, although rare fatal complications have been described. We herein report the first case of fatal hemobilia after transjugular liver biopsy. A patient with alcoholic liver cirrhosis developed hematemesis 1 day after transjugular liver biopsy. Upper gastrointestinal endoscopy revealed bleeding from the papilla of Vater. Despite early intervention by angiography and embolization of an arteriobiliary fistula, the patient deteriorated and ultimately died due to multiorgan failure.