Liver biopsy: Small procedure with large complications

Abstract

Percutaneous ultrasound guided liver biopsy is a routine procedure done on outpatient basis. Sedation or anaesthesia is usually required for uncooperative and paediatric or neonatal patients. A neonate at 20th day of life, weighing 2.7 kg was admitted to our institution for persistent jaundice and nasal bleed and blood in stool for last 2 days. Parents gave history of high coloured urine and yellowish discolouration of sclera since birth. His liver function tests were deranged (AST/ALT: 167/180 U/l; alkaline phosphate: 1595 U/l and serum bilirubin total /direct: 21/9 mg/dl) with a normal coagulation profile. USG abdomen showed mild hepato-splenomegaly with contracted gall bladder. No extra hepatic biliary tract obstruction was seen. Percutaneous ultrasound guided liver biopsy was planned.