Liver Biopsy for Diagnosis of Liver Diseases | Hepatitis of Liver

What is Liver Biopsy?

Liver Biopsy is a safe, simple and valuable method for diagnosis of liver diseases.

Chronic Hepatitis with or without cirrhosis is the most important indication.
In patients with chronic active hepatitis on steroids or antiviral therapy, it helps to assess the effects of therapy.
It helps to diagnose types of cirrhosis, non cirrhotic portal fibrosis, alcoholic liver disease, drug induced hepatitis, storage disorders such as amyloidosis and glycogen storage disorders.
In patients with space occupying lesions such as granulomas due to tuberculosis or malignancy, liver biopsy should be best done under vision during laparoscopy.

Patient is admitted to the hospital for liver biopsy.
Hemoglobin should be around 10 gram %.
Blood group should be known and facilities for blood transfusion must be available.
Platelet count, bleeding count, clotting count and prothrombin must be within normal limits
Procedure is normally done on a fasting patient under local anesthesia without sedation, using intercostals technique (8^th or 9^th space) with the patient holding his breadth in expiration for a few seconds during puncture.
Several needles are available for liver biopsy.
The menghini needle obtains a specimen by aspiration it has diameter of 1.4 mm, oblique tip and has a blunt nail within its shaft to prevent fragmentation of specimen.
The trucut needle is a sheathed needle with 1.7 mm diameter and biopsy with it is obtained by cutting process.

Liver biopsy is contraindicated in patients with suspected angiomas, coagulation disorders, in patients with tense ascites, hydatid cyst of liver.
Complications of liver biopsy include serious intra-peritoneal or intra-thoracic hemorrhage, pleurisy and Intra hepatic haematomas.
Therefore liver biopsy though simple to perform must be done with utmost care by an experienced person.

June 28, 2009 | Filed Under Digestive Disorders

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