What are the possible complications of percutaneous liver biopsy?

Updated: Nov 21, 2019
  • Author: Gaurav Arora, MD, MS; Chief Editor: Kurt E Roberts, MD  more...
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Pain may develop at the biopsy site or in the right shoulder (referred pain). This is the most common adverse effect, [18] occurring in as many as 25% of patients. Treatment should not require more than a single dose of an analgesic

Hypotension is commonly caused by vasovagal reaction and is a frequent cause of hospitalization (together with pain). It may be a sign of hemorrhage.

Hemorrhage [19, 20]  manifests as hypotension, tachycardia, and abdominal pain, usually within 3-4 hours of biopsy. Postbiopsy bleeding has been reported to occur in as many as 10.9% of cases, though the great majority of studies cite figures lower than 2%. [21] Presentations of postbiopsy bleeding include the following:

  • Subcapsular hemorrhage (usually asymptomatic; may cause pain)
  • Intrahepatic hemorrhage (usually asymptomatic)
  • Intraperitoneal hemorrhage (most serious bleeding complication; rare)
  • Hemobilia (very rare; four cases in a series of more than 68,000 patients)

In cases where there is increased concern about possible bleeding, plugged percutaneous biopsy, which involves embolization of the biopsy tract, may be considered. [22]

Other potential complications are as follows:

  • Unintentional biopsy of other organs, such as lung, kidney, or colon (rare)
  • Biliary peritonitis (rare)
  • Pneumothorax or hemothorax (rare) [23]
  • Transient bacteremia (mostly inconsequential)
  • Death (death rate, one in 10,000-12,000 patients) [24, 25]

Portal vein thrombosis after percutaneous liver biopsy has also been reported. [26]  

Needle-tract seeding is a rare potential complication. [27]

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