A Case of Fatal Bile Peritonitis Following Liver Needle Biopsy

IT is the purpose of this paper to present a case of fulminating bile peritonitis and death following liver needle biopsy and to point out the hazard of this proce-dure in cases of obstructive jaundice. No case of death due to bile peritonitis following liver needle biopsy has as yet been reported. Several authors list this danger as a theoretical possibility (Ro-holm, Krarup and Iversen,1 Hoffbauer2). The former believe that in two in-stances of liver needle biopsy they aspirated pure bile from either a large dilated bile duct or from the gall-bladder. Since the first use of liver needle biopsy by Lucatello3 in 1895, 14 deaths from complications have been reported in the litera-ture, 12 thoroughly reviewed by Hoffbauer2 in 1947, and two reported by Klofer4 in 1940. All of the fatalities except two resulted from hemorrhage. In the latter two, the deaths could not be unequivocally attributed to the procedure. Several non-fatal cases with clinical signs and symptoms of localized peritonitis following liver needle biopsy have been described in the literature.