Dataset Information

Hemobilia following Percutaneous Liver Biopsy in the Setting of Malignancy (with Video): Diagnosis and Management of a Rare Cause of Upper Gastrointestinal Bleeding.

ABSTRACT: A 57-year-old gentleman with a past medical history of well-differentiated pancreatic neuroendocrine tumor (NET) with liver metastases was transferred to our hospital with abdominal pain. He underwent percutaneous liver biopsy three days prior to admission as a part of a study protocol for treatment of his progressive NET. He developed gastrointestinal bleeding and was found to have a distended gallbladder filled with high density material on ultrasound. During initial upper endoscopy, it was noted that he had blood emanating from the duodenal papilla consistent with hemobilia and he was ultimately diagnosed with post-liver biopsy hemorrhage. At first, he was managed conservatively with supportive care, but bleeding persisted resulting in the need for arterial embolization as a more effective treatment modality. Hemobilia is a rare entity and in the modern era it is most commonly the result of iatrogenic injury. Appropriate management depends on the underlying etiology with most cases resolving with conservative management. The avoidance of unnecessary surgery and the use of embolization are key principles in management.

SUBMITTER: Pabla B

PROVIDER: S-EPMC6398082 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Hemobilia following Percutaneous Liver Biopsy in the Setting of Malignancy (with Video): Diagnosis and Management of a Rare Cause of Upper Gastrointestinal Bleeding.

Pabla B B Porayko M M

Case reports in gastrointestinal medicine 20190217

A 57-year-old gentleman with a past medical history of well-differentiated pancreatic neuroendocrine tumor (NET) with liver metastases was transferred to our hospital with abdominal pain. He underwent percutaneous liver biopsy three days prior to admission as a part of a study protocol for treatment of his progressive NET. He developed gastrointestinal bleeding and was found to have a distended gallbladder filled with high density material on ultrasound. During initial upper endoscopy, it was no ...[more]

PMID: 30906600

Similar Datasets

Project description:BackgroundUpper gastrointestinal (GI) bleeding is one of the most common, high risk emergency disorders in the western world. Almost nothing has been reported on longer term prognosis following upper GI bleeding. The aim of this study was to establish mortality up to three years following hospital admission with upper GI bleeding and its relationship with aetiology, co-morbidities and socio-demographic factors.MethodsSystematic record linkage of hospital inpatient and mortality data for 14 212 people in Wales, UK, hospitalised with upper GI bleeding between 1999 and 2004 with three year follow-up to 2007. The main outcome measures were mortality rates, standardised mortality ratios (SMRs) and relative survival.ResultsMortality at three years was 36.7% overall, based on 5215 fatalities. It was highest for upper GI malignancy (95% died within three years) and varices (52%). Compared with the general population, mortality was increased 27-fold during the first month after admission. It fell to 4.3 by month four, but remained significantly elevated during every month throughout the three years following admission. The most important independent prognostic predictors of mortality at three years were older age (mortality increased 53 fold for people aged 85 years and over compared with those under 40 years); oesophageal and gastric/duodenal malignancy (48 and 32 respectively) and gastric varices aetiologies (2.8) when compared with other bleeds; non-upper GI malignancy, liver disease and renal failure co-morbidities (15, 7.9 and 3.9); social deprivation (29% increase for quintile V vs I); incident bleeds as an inpatient (31% vs admitted with bleeding) and male patients (25% vs female).ConclusionOur study shows a high late as well as early mortality for upper GI bleeding, with very poor longer term prognosis following bleeding due to malignancies and varices. Aetiologies with the worst prognosis were often associated with high levels of social deprivation.

Dataset Information

Hemobilia following Percutaneous Liver Biopsy in the Setting of Malignancy (with Video): Diagnosis and Management of a Rare Cause of Upper Gastrointestinal Bleeding.

Publications

Hemobilia following Percutaneous Liver Biopsy in the Setting of Malignancy (with Video): Diagnosis and Management of a Rare Cause of Upper Gastrointestinal Bleeding.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets