Hepatic hemorrhage
Diagnosis certain
Updates to Case Attributes
Race
changed from Caucasian to .
Age
changed from 49 to 50.
Presentation
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Ongoing life-threatening liver bleeding(haemoperitoneum) post-liver biopsy in a patient with end stage cirrhosis and advanced liver failure. Bilirubin >400.
INR rapidly increased after the liver liver biopsy indicating grossly impaired synthetic function. In the 12 hours prior to the attempted embolisation of the site of haemorrhage the patient was anuric with a systolic blood pressure having dropped to 60mmHg and requiring ICU support. Large volume transfusions of products were given to to correct the coagulopathy - INR reduced from 6.6 to 1.8. Post 5 unit unit blood transfusion - Hb had not improved.
-<p>Ongoing life-threatening liver bleeding(<a href="/articles/haemoperitoneum" title="haemoperitoneum">haemoperitoneum</a>) post-<a href="/articles/trans-jugular-liver-biopsy" title="Transjugular liver biopsy">liver biopsy</a> in a patient with end stage cirrhosis and advanced liver failure. Bilirubin >400. </p><p>INR rapidly increased after the liver biopsy indicating grossly impaired synthetic function. In the 12 hours prior to the attempted embolisation of the site of haemorrhage the patient was anuric with a systolic blood pressure having dropped to 60mmHg and requiring ICU support. Large volume transfusions of products were given to to correct the coagulopathy - INR reduced from 6.6 to 1.8. Post 5 unit blood transfusion - Hb had not improved. </p>- +<p>Ongoing life-threatening liver bleeding (<a href="/articles/haemoperitoneum">haemoperitoneum</a>) post-<a href="/articles/trans-jugular-liver-biopsy">liver biopsy</a> in a patient with end stage cirrhosis and advanced liver failure. Bilirubin >400.</p><p>INR rapidly increased after the liver biopsy indicating grossly impaired synthetic function. In the 12 hours prior to the attempted embolisation of the site of haemorrhage the patient was anuric with a systolic blood pressure having dropped to 60mmHg and requiring ICU support. Large volume transfusions of products were given to to correct the coagulopathy - INR reduced from 6.6 to 1.8. Post 5 unit blood transfusion - Hb had not improved.</p>
Diagnostic Certainty
was set to
.