Episode 288: WDx #23: Clinical Unknown Discussion with Dr Rebecca Berger
The Clinical Problem Solvers
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Transjugular Hepatic Biopsy: A Better Way to Measure Portal Pressures
Thrombus is the most obvious cause to me of something that would cause occlusion and therefore abnormal architecture of somebody's hepatic vasculature. The reason to do a trans jugular liver biopsy instead of a trans hepatic liver biopsy is really to be able to measure portal pressures. If someone does have coagulopathy, which is obviously quite common in patients who we are getting liver biopsies on, then trans jugular can be safer because you can then apply pressure to the site. It doesn't sound like we're dealing with an inflammatory process, like a malignancy, and it doesn't look like she's infected based on the neutrophil count
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