Following a bone marrow biopsy in a patient with thrombocytopenia, which site requires close inspection for bleeding?

• A. Aspiration site
• B. Injection site
• C. Umbilical site
• D. Port-a-cath site

Answer: (A)

Bleeding risk after a invasive puncture is highest at the actual puncture site, especially when platelets are low. A bone marrow biopsy is done by inserting a needle into the posterior iliac crest to obtain marrow, so in a patient with thrombocytopenia the site of that needle track is where oozing or hematoma is most likely to appear. Close inspection helps catch early bleeding and allows prompt management, such as applying direct pressure and monitoring platelets or providing transfusion if needed. The other sites mentioned are not involved in the biopsy: an injection site is for a routine injection elsewhere, the umbilical site isn’t used in adults for marrow sampling, and a Port-a-cath site is for central venous access and not the biopsy puncture.