2006 Volume 33 Issue 6 Pages 673-679
A 63-year-old female was admitted to our hospital suffering from abdominal pain with anemia and liver dysfunction on hematological examination. She had undergone percutaneous liver biopsy eight days before because of suspected autoimmune hepatitis. Ultrasound examination on admission revealed dilatation of the common bile duct and color Doppler sonogram showed “color mosaic appearance” at the anterior segment, the site of the prior percutaneous biopsy in the right lobe of the liver. The waveform of the signal on pulsed Doppler sonogram showed a predominant turbulent flow, which was considered to correspond to pseudoaneurysm secondary to liver biopsy. Since endoscopy examination showed bleeding at the orifice of the papilla vater, she was diagnosed with hemobilia secondary to liver biopsy, and biliary drainage was performed. Following this, without having to resort to transcatheter arterial embolization (TAE), she showed no bleeding, and both the clinical symptom and laboratory data improved. The “color mosaic appearance” disappeared following a decrease in size, as did the turbulent flow, and she was released. A “color mosaic appearance” on color Doppler sonogram may be an important sign for the early diagnosis of intrahepatic pseudoaneurysm, and its reduction or disappearance may be predictive for recovery from the condition without TAE or other intensive treatment.
