Splenic biopsy as an unintended consequence of EUS-guided liver biopsy: a cautionary tale

Diehl, David L.; Mehta, Minesh; Shafqet, Muhammad A.; Confer, Bradley; Khan, Yakub; Khara, Harshit S.; Johal, Amit

doi:10.1016/j.gie.2019.08.010

Cited by 6 publications

(4 citation statements)

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“…33 This includes bleeding, abdominal pain, infection, and inadvertent splenic puncture. 34 A multicenter study involving 110 patients for EUS-LB observed only one complication which was self-limited bleeding in thrombocytopenic patient. 41 Incidence of abdominal pain may be less compared with PCLB and TJLB.…”

Section: Adverse Effects and Complicationsmentioning

confidence: 99%

“…23 It is important to differentiate liver from spleen, due to similar echotexture pattern, as inadvertent puncture of spleen can result in catastrophic bleeding. 33,34 Different types of EUS needles in regard to the size (19 vs. 22 gauge), purpose (aspiration vs. biopsy), and shape (Franssen vs. fork tip) have been described in the Liver Biopsy and Pressure Hemodynamics Kesar et al 283 literature. [35][36][37] A 19-gauge fine needle biopsy (FNB) is the preferred needle choice.…”

Section: Videomentioning

confidence: 99%

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Liver Biopsy and Pressure Hemodynamics: GI Perspective

Kesar,

Monkemuller

et al. 2023

Digestive Disease Interventions

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Endoscopic ultrasound (EUS) has come a long way from mere diagnostic modality to performing interventional procedures like fine needle aspiration, gastric varices glue and coiling, and management of pancreatic fluid collection along with necrosectomy. Recently, EUS-guided biopsy of the liver has gained traction. This coupled with the ability to access the portal vein and measure portal pressure has made comprehensive liver evaluation possible using endoscopic route. In this review, we will discuss evolution and techniques of performing EUS-guided liver biopsy and portal pressure gradient. We will also compare the merits and demerits as compared with the other conventional techniques.

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Section: Adverse Effects and Complicationsmentioning

confidence: 99%

Section: Videomentioning

confidence: 99%

Liver Biopsy and Pressure Hemodynamics: GI Perspective

Kesar,

Monkemuller

et al. 2023

Digestive Disease Interventions

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show abstract

“…Care must be taken to avoid spleen puncture on targeting the left lobe because the echotexture of a fatty liver can be similar to that of the spleen. 24…”

Section: Adverse Eventsmentioning

confidence: 99%

“…EUS‐LB might be unsafe in patients with a coagulopathy (platelets <50,000) or an international normalized ratio >1.5. Care must be taken to avoid spleen puncture on targeting the left lobe because the echotexture of a fatty liver can be similar to that of the spleen 24 …”

Section: Eus‐guided Liver Biopsymentioning

confidence: 99%

Endoscopic ultrasound guided hepatic interventions

Hashimoto

Chang

2020

Digestive Endoscopy

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Intervention for liver disease has predominantly been performed through the percutaneous approach. However, as endoscopic ultrasound (EUS) applications have expanded, there have emerged various EUS-guided interventions for liver disease, a space we call "Endo-Hepatology". EUS-guided liver biopsy can be considered the "forerunner" of Endo-Hepatology and has become a clinical option for patients requiring histologic diagnosis and staging of their liver disease. EUS also enables direct access to the portal vein. Subsequently, many procedures are being explored, such as angiography, measurement of the portosystemic pressure gradient, portal vein sampling to detect cancer cell or DNA, and EUS-guided transhepatic intrahepatic portosystemic shunt creation. Since the transducer is close to the liver, especially the left and caudate lobes, EUS can be used as a rescue when the percutaneous approach is not favorable and EUS-guided treatments of liver tumor, cyst and abscess have been reported. This review summarizes the available studies of EUS-guided intervention in the liver.

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How to do Endoscopic Ultrasound‐guided Liver Biopsy

Diehl

2021

Atlas of Endoscopic Ultrasonography

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Splenic biopsy as an unintended consequence of EUS-guided liver biopsy: a cautionary tale

Cited by 6 publications

References 0 publications

Liver Biopsy and Pressure Hemodynamics: GI Perspective

Liver Biopsy and Pressure Hemodynamics: GI Perspective

Endoscopic ultrasound guided hepatic interventions

How to do Endoscopic Ultrasound‐guided Liver Biopsy

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