Pseudoaneurysm and hemobilia in a neonate

Hemobilia, arterial-biliary fistula, and pseudoaneurysm are rare complications of percutaneous liver biopsy in a neonate. We present the management of persistent hemobilia in a previously premature 2877 g neonate. Despite the ongoing correction of coagulation parameters and multiple large volume transfusions our patient's hemobilia persisted. We eventually controlled the arterial-biliary fistula using a selective endovascular embolization technique not commonly used in patients of this size. The pseudoaneurysm was no longer visible on outpatient follow up ultrasound 21 days after embolization. Pseudoaneurysm should be considered in the neonate with persistent hemobilia after percutaneous liver biopsy. Angiography can be both diagnostic and therapeutic in the management of hepatic pseudoaneurysm and arterial-biliary fistula after percutaneous liver biopsy. (C) 2013 Elsevier Inc.