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December 5, 1977

Balloon Occlusion of Segmental Hepatic ArteriesControl of Biopsy-Induced Hemobilia

JAMA. 1977;238(23):2524-2526. doi:10.1001/jama.1977.03280240070026

LIVER biopsy, both percutaneous and during laparotomy or laparoscopy, has become a widely used diagnostic technique. The complications include bile peritonitis, bleeding, and communications between the vascular and biliary systems, which may result in hemobilia. Therapy for hemobilia usually requires hepatic artery ligation or hepatic lobe resection; the attendant risks are high. Walter et al1 recently reported angiographic control of biopsy-induced hemobilia using absorbable gelatin sponge (Gelfoam) emboli. Two additional reports2,3 were made in which this same technique was used. We present an alternate technique using a balloon catheter to temporarily occlude a hepatic artery branch and control biopsy-induced hemobilia.

Report of a Case  A 50-year-old woman had abdominal pain and epigastric fullness. A biopsy specimen of an axillary lymph node showed poorly differentiated nodular lymphocytic lymphoma. Her condition was staged IVA with an abnormal lymphangiogram; bone marrow and percutaneous liver biopsy specimens also showed lymphoma. She received