Percutaneous liver biopsies were performed in 40 adult patients with acute or chronic liver disease. Real-time sector scan ultrasound of the right upper quadrant was obtained just before biopsy, 1 day after biopsy, and in 10 randomly selected cases 7 days after biopsy. Twenty patients were randomized, by sealed envelope, to 6-h and 20 patients to 24-h postbiopsy bed rest. Nine patients (23%) had ultrasound-detected hematomas 1 day after liver biopsy (7 intrahepatic, 2 subcapsular). Five of these patients had been randomized to 6-h and 4 to 24-h bed rest. Follow-up ultrasound at 7 days in the 10 randomly selected patients failed to reveal any hematomas not seen on day 1 (n = 6) and showed complete or partial resolution of those that had been detected previously (n = 4). Significant drops in systolic and diastolic blood pressures and increases in pulse rate were common postbiopsy findings, and were unrelated to hematoma formation. The results of this study indicate that intrahepatic and subcapsular hematomas are common after percutaneous liver biopsy. The length of postbiopsy bed rest (6 vs. 24 h) does not appear to influence the frequency of this complication.
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