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May 15, 1948

DISEASE OF THE LIVER: A Review of Some Clinical and Biochemical Problems as Revealed by Systematic Biopsy Studies.

Author Affiliations

London, England

Professor of Medicine, University of London: Director of the Department of Medicine, Postgraduate Medical School of London.

JAMA. 1948;137(3):234-236. doi:10.1001/jama.1948.02890370016004

Needle biopsy of the liver was first performed by Paul Ehrlich about 1883 and since then nearly 2,500 biopsies are on record.1 Used widely in tropical medicine for the detection of amebic abscesses, it was recently revived for systematic use by Iversen and Roholm,2 who recorded 160 liver punctures without a death. My associates and I began to use the method in the British Postgraduate Medical School in 1941 with the confidence suggested by Iversen and Roholm's report of its safety and in view of the urgent problems of hepatitis resulting from the war. In our first 150 biopsies we had 2 cases of intraperitoneal hemorrhage leading to death, both patients, however, having a degree of damage to the liver so severe that puncture only accelerated an already certain fatal issue. At that stage, however, we reviewed the technic and changed from a 2 mm. bore to a