Gastroenterology

Gastroenterology

Volume 102, Issue 2, February 1992, Pages 629-632
Gastroenterology

Complications of percutaneous liver biopsy in children

https://doi.org/10.1016/0016-5085(92)90112-CGet rights and content

Abstract

To determine the frequency and nature of complications after liver biopsy and whether risk factors could be identified to predict these complications, the medical records of all patients (age, 1 week to 28 years) who underwent a percutaneous liver biopsy at Children's Hospital over a 6-year period (1981–1986) were reviewed. Data were collected from 469 (97%) of 483 eligible charts. Twenty-one patients (4.5%) experienced major complications including bile leak (n = 3, 0.6%), prolonged drainage of ascitic fluid (n = 1, 0.2%), pneumothorax (n = 1, 0.2%), bleeding requiring transfusion (n = 13, 2.8%), and death (n = 3, 0.6%). A subgroup of patients (n = 37) with cancer or bone marrow transplantation was found to be at a nearly fivefold greater risk for transfusion than patients with other diagnoses (P = 0.02). All three deaths in previously stable patients occurred in this same high-risk group of patients with cancer or bone marrow transplantation (P < 0.001). Two deaths resulted from disseminated intravascular coagulation and one from bleeding. Diagnosis, age, number of percutaneous passes, and prebiopsy coagulation studies were not predictive of subsequent complications. It is concluded that bleeding that requires transfusion is the most common liver biopsy complication and that it occurs more frequently in children than previously reported. Children with cancer or those who have undergone bone marrow transplantation are at a greater risk for bleeding and death following percutaneous liver biopsy.

References (13)

There are more references available in the full text version of this article.

Cited by (90)

  • Magnetic Resonance Elastography of the Liver in Children and Adolescents: Assessment of Regional Variations in Stiffness

    2020, Academic Radiology
    Citation Excerpt :

    Biopsies are invasive and there are limitations regarding sampling errors and high inter and intraobserver variability (3–5). The practice also has constraints in pediatric care (6–8). More recently, alternative and quantitative noninvasive imaging methods based on ultrasound (6–11) and magnetic resonance elastography (MRE) have emerged in the clinical setting (12–22), with extensive evidence of diagnostic utility in both pediatrics and adults.

  • Liver Failure

    2020, Pediatric Gastrointestinal and Liver Disease, Sixth Edition
  • Utility of liver biopsy in the evaluation of pediatric total parenteral nutrition cholestasis

    2018, American Journal of Surgery
    Citation Excerpt :

    Therefore, if the patient is being taken to the operating room for an abdominal surgery, the surgeon is often asked to obtain an intraoperative liver biopsy. Complication rates of liver biopsy in the literature range from 0.2% to 6.5%19–23 which is consistent with our study findings. The main complication reported is bleeding22; however, only one patient in our study suffered a complication and this was apnea after anesthesia administration.

  • Blind percutaneous liver biopsy in infants and children: Comparison of safety and efficacy of percussion technique and ultrasound assisted technique

    2016, Arab Journal of Gastroenterology
    Citation Excerpt :

    Scheimann et al. [10] reported a 6.83% incidence of overall complications in a retrospective study done in 249 biopsies and a 2.4% incidence of major complications and the mortality rate was 0.4%. Whereas, Cohen et al. [36] stated that major complication rate was 4.5% in a retrospective review of unguided percutaneous liver biopsies in 483 children of all ages. On a large study done on 513 paediatric patients using ultrasound guided technique, Matos et al. [22] reported rate of minor complications of 7.4% and major complications of 1%.

View all citing articles on Scopus

Supported in part by USPHS Grant DK-1908 from the National Institutes of Health, an AGA/Industry (Glaxo) Research Scholar Award, and USPHS grant RR-00123 from the GCRC Branch, Division of Research Resources, National Institutes of Health. Computational analysis was performed with the help of CLINFO at The General Clinical Research Center at the University of Cincinnati; funded by the Division of Research Resources (RR-0068) of the National Institutes of Health.

View full text