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Endoscopic ultrasound-guided liver biopsy: down but not out
  1. Nadeem Akhter Tehami1,2,
  2. Keith Siau3,
  3. Ryan Buchanan1,
  4. Eleanor Jaynes4,
  5. Ben Maher2,5
  1. 1Department of Hepatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2Interventional Endoscopy Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  3. 3Department of Gastroenterology, Dudley Group Hospitals NHS Foundation Trust, Dudley, UK
  4. 4Department of Histopathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  5. 5Department of Interventional Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Dr Nadeem Akhter Tehami, Hepatology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; nadeem.tehami{at}nhs.net

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The paper by Bang et al1 is a much-needed randomised study, which concluded that conventional ultrasound-guided percutaneous liver biopsy was superior to the relatively new endoscopic ultrasound (EUS)-guided approach. We wish to share two recent cases where EUS-guided liver biopsy safely and effectively provided a definitive diagnosis, and debate the conclusions raised by the authors.

In the first case, a 55-year-old woman with lupus was referred with transaminitis, mild IgG elevation and ultrasound evidence of splenomegaly and unexplained dilatation of the common bile duct (16 mm) confirmed on MRI. Elastography revealed elevated liver stiffness of 21 kPa. In a single visit, she underwent gastroscopy for variceal screening, EUS-guided assessment for ductal dilatation and EUS-guided liver biopsy. An adequate sample was obtained and a diagnosis of moderate …

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Footnotes

  • Twitter @helpatologist, @drkeithsiau

  • Contributors All authors contributed equally.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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