Complications after liver biopsy - British Liver Trust

British Liver Trust

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Complications after liver biopsy


I had needle liver biopsy back in early February. They took 2 samples and used only lidocaine in order to numb the site immediately prior to the biopsy being done and repeated.

The experience itself was incredibly painful, and moved into general discomfort later the same day. After 3 days, the pain got wose and it felt like the stitch in your side you get when running, but worse...and it never goes away. After a few weeks, it went away and I thought it was behind me..

A few weeks later, it popped back up again with the same, but worse symptoms. I'm going to see my GP next week, as he is easier to get into than my specialist.

It's rare to be able to find virtually no information at all online anywhere as to what could be going on. Does anyone here have any insight or simillar experience?

25 Replies

Get your platelets etc checked to make sure there is no internal bleeding. If your liver was highly inflamed at the time it does tend to be a more painful procedure than if the liver is normal. They may have nicked a nerve or perhaps caught the Glisson capsule in a sensitive spot.

Good idea to get GP to give you the once over.

PainfulMe in reply to Bolly

Thank you for taking the time to respond... For some reason, the deeper I get into the treatment of the chronic conditions I face...the more I realize that I constantly fall into latter category when it comes to " Most people are fine with this/see success with this, however a small portion of the population...yada yada yada...."

I'm just hoping it is a -something- instead of a "Well, who knows"...because I'm not sure I can accept this as just another part of daily painful life...this one is actually much worse and the morphine doesn't really cut into it... :(

Bolly in reply to PainfulMe

You say there is virtually no information online. What condition was the background reason for the biopsy and we might be able to point in the right direction for more information.

Were you already on morphine before the biopsy or has someone prescribed this for you after the procedure. You should not been suffering day to day using morphine. Some do get pain yes, some don't, not many need morphine for weeks afterward unless there is another pre existing condition that might cause complications.

If your doctors are responding to questions with "who knows" or "yada yada" you could do better with a different doctor, lol!

Ps. Have looked at your other posts, I see you have a long history of severe pain for endometriosis. Could this be the reason for your current extra pain and perhaps a resistance developing to opioids? The elevated enzymes could well be connected to long terms use, as the liver processes toxins from medications along with all its other functions. Are the docs trying to exclude other causes of the elevated enzymes with the biopsy, or checking for damage?

PainfulMe in reply to Bolly

My enzymes were initially detected to be elevated over a year ago,and they've grown higher since. I also have a positive smooth muscle antibody with a title level of 1:20. Generally speaking, this list amounts to autoimmune hepatitis. Given that I have other autoimmune conditions and a family history of even more, this is still what they think might be the issue, but at this point they aren't able to confirm the diagnosis.

As for the drugs... I've actually been quite good at taking the occasional drug holiday (though it is hell) and mitigate the amount I take in order to avoid both chemical and mental dependence. Unfortunately I was on a number of other drugs prior to progressing to morphine. I take long and short acting and in manageable doses.

Also, it is my understanding that morphine is not processed through your liver the way many other opioids are, generally it is broken down through the other systems in the body prior to making its way through the liver. So in a longer term sense,it's actually not the worse option.

All that being said.. I'm doing what I can do take less and receive relief through other means, such as physio, yoga, mindfulness ,meditation and more.

Bolly in reply to PainfulMe

Sorry to hear the possible addition of AIH. Its a difficult one to diagnose accurately, as the elevated enzymes, elevated immunoglobulins, and positive antibody tests can be diagnostic of other conditions too. My antibody test came back postive to 1:800 one year, the lab said it was actually stronger but their machine couldnt go higher, lol. The next year it went negative, and the next positive again, so dont rely on just blood tests for accuracy!

Generally a hepatologist experienced in AIH would insist on a liver biopsy too, to check for interface hepatitis in the liver tissue, before making a diagnosis. Also they generally look to see how well a possible patient responds to steroids, but as you are already on a number of different medications that test may not be an accurate option.

PainfulMe in reply to Bolly

I have had celiac since I was a teenager, a d from recent scopes and biopsies, it is 100% controlled through diet.... but even with that, my C Reactive Protein is quite high as well... so add that to the list of "things we can't answer". Right now the response from my GI /liver guy was "if you get worse, we will have more answers"

Guess right now it is waiting to see if they partially collapsed my right lung during the biopsy....

Sorry to hear that you are in much the same boat. Do you mind me asking your symptoms, and diagnosis?

Bolly in reply to PainfulMe

My symptoms have never been clear cut as i have long term chronic hepatitis plus cirrhosis plus autoimmune hepatitis plus i had liver cancer 5 years ago. All of these have overlap symptoms; fatigue, myalgia, digestives issues, night sweats, headache... the list goes on. But people with 'just' AIH would probably say fatigue, aches and pains in joints and muscles, cramps, night sweats and gut disorders are probably the most common.

Most of us try and avoid painkillers if possible, as we are not allowed to take NSAIDS and not allowed to take the full dose of paracetamol (Acetaminophen). The medications for AIH comes with its own side effects, and often its impossible to say 'thats an AIH symptom' or 'thats a medication side effect'. Everyone is different.

I hope you get the biopsy after effects clarified and dealt with.

Are you in Canada? Treatment protocols may be different to the UK.

PainfulMe in reply to Bolly

Thank you for being so open about your own condition and so helpful with mine. It sounds like you have been through hell and bsck.

Are you on immunosuppressants and steroids? Have you found a treatment that your body reacts positively to? How were they able to confirm your diagnosis?

I've been off work for for over a year and a half. With very little all so very frustrating...

Syl (The Canadian,eh! )

Bolly in reply to PainfulMe

For AIH in the uk the standard diagnosis is by testing liver enzymes, immunoglobulins, auto antibodies, response to steroids, and a liver biopsy. Obviously in a suspected acute case the doctors would probably start the patient in steroids before completing all tests. But in a more slowly developing case the doctors might spend longer running tests, especially if as in your case there are other conditions blurring the symptoms and other meds that might contraindicate AIH medication.

I was on high dose steroids (60mg) for a couple of weeks, then down to 40, 30, 20 etc. It took 6 months to wean me off. After a month(ish), can't remember exactly Azathioprine was introduced at 25mg to see if I tolerated it, then upped to 50mg while the steroids were repeatedly reduced.

I've been fine on that for 3 years until I picked up a virus that was doing the rounds of work. The Aza has reduced my virus fighting lymphocytes to zero, so I have no natural ability to fight this and have been quite poorly. Something similar happened last summer when it was thought I had a re-activation of Epstein Barr. So just because one condition may be stable, it's a juggling act and balancing act, as something as simple as a cough or cold or flu virus etc can knock everything out of balance again!

dooley1 in reply to PainfulMe

Hi you're right most people you talk to or read about say that a biopsy isn't too bad but I too had a very painful biopsy with only lidocaine, I've got a high pain threshold but this floored me and I ended up passing out. I felt very traumatised but when I went for my follow up scan the nurses told be it was a trainee doc who did it and he was obviously inexperienced. I found it painful afterwards too and still have considerable discomfort there but have never had any sensible explanation. You need to talk to your GP- hopefully yours is helpful!! and get to the bottom of it. a Good luck. 👍🏼

PainfulMe in reply to dooley1

Hi there. How long ago was your biopsy? You still have pain? Was it conclusive?

dooley1 in reply to PainfulMe

My biopsy was a year ago it's better than it was but I definately still have discomfort. Never resolved, I had a CT scan 6 months ago but still haven't received results despite chasing it up!!

PainfulMe in reply to dooley1

Wow... that's insane! I'm sorry to hear that. Are you in the Uk?

dooley1 in reply to PainfulMe

Yes I'm in Wales.

I had horrendous pain after my biopsy, needed morphine then given very strong pain killers. Pain lasted many many weeks.

PainfulMe in reply to bantam12

Ouch :( it's a horrible procedure that I wouldn't wish on anyone. Was yours productive at least? Did your symptoms subside?

bantam12 in reply to PainfulMe

No it was a waste of time, they still don't know why my enzymes are high and have lost interest.

At the time the Hep thought he must have nicked my diaphragm hence the pain especially with breathing. I also had massive bruising that lasted weeks.

Hope you are sorted soon.

I almost bled to death after mine in 2004. I had horrid pain, they thought I was over reacting, then 3 hours later they wanted to send me home but my liver was contracting horribly by then and I could not sit up. Then they believed me. I got lucky after two more hours of contractions and my liver bleeding it stopped. My doctor was relieved as he told me I was in a life threatening situation and there was nothing that could be done. In 2014 I almost bled to death twice. We really are strong. Pursue this, find out what it could be, its likely to heal. Try to avoid being angry or afraid. It uses up our clarity to think and we really have our hands full getting correct information from doctors or I do.

Apparently my side is discoloured and I'm on my way for xrays for a possible pneumothorax. Also, a trip to the vampires.

Thanks for everyone's thoughts,experiences and ideas, I'll keep you posted

Have pressure feeling in my side and mid upper stomach after my liver biopsy and some pain is this normal

Hi PainfulMe,

Just wondering if you ever found any answers to your liver biopsy experience? I too had a liver biopsy about 4 months ago due to elevated liver enzyme levels shown in a blood test. Ultrasounds and fibroscans showed up normal. I had no other symptoms of anything wrong.

Ever since the biopsy, however, I have had on and off ‘stitch-like’ pain. I thought it was finally gone last month, but it’s started to hurt again this week.

Any answers?

I gad a biopsy 2 weeks ago and found it all as I expected. No more painful than i would have imagined, in fact less so. I didn’t even require any pain relief afterwards. Although now 2 weeks in i have a steady ache under

My ribs, nearer my back. Cant decide

If its muscular or liver related. How bad does it need to be before we ask a dr?

I too had a liver biopsy three months ago because of elevated liver enzymes. After the biopsy and scan they found I had mild hepatitis. No treatment given. It had taken four years for this diagnosis and they Sent me away saying no liver damage as yet. However I still get discomfort at my biopsy site. I was told by the specialist to ignore it as it was “all in my head”. Very frustrated and angry. Would be interested to know your outcome

Hello There,

I know this is years later but I've been scouring the net with info to perhaps explain why I'm having similar sharp pains post liver biopsy (1 week later). Hurts to breathe, can't tell if its muscular or something else but deep breaths hurt, laughing and hard to bend. Slight chills, tenderness and can only take quick shallow breaths. I have ultrasound, CT chest scan and appt with my doctor in two days but this pain doesn't feel normal. Have you found the cause to this pain? Has it subsided? I do hope you and anyone else here reading this is well.

Thanks in advance.

job1121 in reply to BlameLupus

BlameLupus This is exactly how i feel - i had liver biopsy and my gallbladder removed four days ago. This pain is horrible and can’t be normal. Did you figure out what was causing this pain for you, or did it eventually subside??

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