Delayed massive hemobilia following percutaneous liver biopsy: treatment by embolotherapy.

A patient developed delayed life-threatening hemobilia after apparently uncomplicated percutaneous needle liver biopsy. An arteriobiliary fistula demonstrated by arteriography was successfully treated by selective transcatheter arterial embolization, with Gelfoam and a Gianturco coil. The diagnosis of liver biopsy-induced hemobilia should be suspected when a postprocedure fall in hematocrit is associated with abdominal pain, hyperbilirubinemia, or unexplained gastrointestinal bleeding. A review of the diagnosis and management of liver biopsy-related hemobilia is presented.