Introduction. Arteriovenous fistula is one of the complications that can
occur during percutaneous liver biopsy. Hepatic arterio-venous fistula with
chronic bleeding from the puncture site on the skin is extremly rare
complication following percutaneous liver biopsy. Case report. The case
represents a 35-year-old woman with secondary anemia caused by chronic
bleeding at the site of a granuloma caused by a previous liver biopsy done 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 was detected on a CT 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. Tumor mass was removed by atypical resection of
VI and VII liver segments. Due to hemorrhage, re-exploration was performed,
where bleeding was found from the surface of the resected liver parenchyma.
Two weeks after the last operation, the patient was released for home
treatment. Conclusion. Although percutaneous liver biopsy is a safe
procedure, the complication in the form of bleeding occurs in less than 25%
of cases and with spontaneous cessation. In our presentation, there was a
complicated intrahepatic arteriovenous-portal fistula with the formation of
communication with the puncture site on the skin. This is the first case of
complications of this type after percutaneous liver biopsy.
Bleeding hepatico-cutaneous fistula: Unusual complication of the percutaneous liver biopsy
