What are the contraindications for percutaneous liver biopsy?

Updated: Nov 21, 2019
  • Author: Gaurav Arora, MD, MS; Chief Editor: Kurt E Roberts, MD  more...
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Answer

Contraindications include the following:

  • Uncooperative patient [8]
  • Inability to identify a suitable biopsy site by means of either percussion or ultrasonographic (US) guidance
  • Prolonged (>1.5) international normalized ratio (INR) [9]
  • Decreased platelet count (< 60,000/μL)
  • Bleeding diathesis (eg, hemophilia)
  • Recent use (within the last 7 days) of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) or antiplatelet class of medications
  • Unavailability of blood products for transfusion
  • Morbid obesity of patient
  • Ascites
  • No backup support available from surgery or interventional radiology in case of a complication
  • Abdominal-wall infection over the identified biopsy site
  • Infection in the right pleural cavity or below the right hemidiaphragm
  • Bowel overlying biopsy site (on US or other abdominal imaging)

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