ArticleInternational journal of surgery case reports2026
Portobiliary fistula after liver biopsy in a young transplant patient presenting with GI bleeding and hemorrhagic shock managed by embolization: a case report.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Gastrointestinal (GI) bleeding in liver transplant recipients is diagnostically and therapeutically challenging, particularly when routine evaluations fail to identify a source. Rare vascular causes must be considered when standard workups are inconclusive. Presentation of case: A 23-year-old male with a complex history of four liver transplants over several years for chronic rejection related to medication noncompliance experienced recurrent episodes of obscure GI bleeding over months. Extensive evaluation - including multiple upper and lower endoscopies, nuclear tagged-red blood cell scans, and CT angiography - was repeatedly negative. Ultimately, provocative mesenteric angiography revealed a portobiliary fistula, felt to be iatrogenic following a percutaneous liver biopsy. The lesion was successfully treated with coil and gelfoam embolization, with complete resolution of bleeding and subsequent normalization of liver function tests. Discussion: This case highlights an uncommon vascular etiology of obscure GI bleeding in the transplant population. Portobiliary fistula/hemobilia should be considered in patients with recurrent, unexplained GI hemorrhage after liver biopsy or invasive hepatobiliary procedures. When intermittent bleeding eludes conventional imaging, provocative angiography can be diagnostic by unmasking occult, intermittent extravasation. Timely endovascular therapy can achieve durable hemostasis while preserving graft function. Conclusion: Clinicians should maintain a high index of suspicion for portobiliary fistula in post-biopsy transplant patients presenting with hemobilia or unexplained GI bleeding. Provocative angiography is a valuable tool for identifying occult bleeding sources, and endovascular embolization offers an effective, organ-sparing treatment. The case also underscores the critical need for strict adherence to immunosuppressive therapy to prevent graft loss and repeated transplantation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.