Liver biopsy needles and procedures —
Menghini’s aspiration biopsy needle
Vim-Silverman cutting needle.
Precautions in Liver biopsy
- Bleeding time should be within normal limits.
- Vein should be patent and blood should be arranged Hydatid cyst, subphrenic abscess, bleeding tendencies should be ruled out.
- Patient should be sedated.
Vim-Silverman liver biopsy needle
- (It has 3 parts) It consists of a long sharp needle, a stilette, prong, or fork which is longer than the needle so that it protrudes out of the needle when inside the needle. Both the fork and the stilette fit inside the needle nicely.
- The fork or prong has very sharp cutting edge. There is no guard on this needle.
Site of puncture —
- Anterior or midaxillary line 2 spaces below the upper edge of liver dullness during full expiration i.e. 9th or 10th right intercostal space.
Procedure of liver biopsy —
- Patient should hold the breath in full expiration.
- The site of puncture is infused with local anaesthetic into the skin.
- The needle is thrust into the liver 2-3 cm deep at the puncture site. The stillete is removed and the prongs are inserted. The prong which projects out of the needle is rotated through 3600 so as to remove a portion of liver tissue between the prongs.
- The tissue is sent for histopathological examination.
Complications of liver biopsy
- · Pleurisy
- · Perihepatitis
- · Intraperitoneal or intrathoracic haemorrhage
- · Intrahepatic hematoma
- · Biliary peritonitis
- · Pulmonary bile embolism
- · Bacteremia.
RENAL BIOPSY Indications
- · Nephrotic syndrome
- · Acute renal failure
- · Undiagnosed proteinuria
- · Hematuria
- · Nephritic syndrome
- · Systemic diseases with renal failure.
biopsy Instrument —
- · Vim – Silverman’s biopsy needle
- · Menghini’s biopsy needle.
- · Bleeding and clotting time should be normal.
- · Blood pressure should be controlled.
- · Plain X-ray abdomen is taken.
- · Sedate the patient.
- · The patient lies on his belly with a pillow under his abdomen.
- · A puncture is made with the Vim – Silverman’s needle on a line between the anterior end of 11 th rib and 2nd lumbar vertebra at the back on the right side.
- · The right side is preferred because of lower position of kidney and because the great vessels are on the left side.
- · The part is cleaned and draped. Local anaesthetic is infiltrated. A small nick is made and puncture needle is introduced into the kidney. When the needle enters the kidney it starts moving in a wide arc with respiration.
- · The stilette is removed and prong is introduced into the renal parenchyma. The prong is advanced till it enters the kidney tissue, it is then rotated in a circle and taken out along with the needle.
- · The patient is asked to remain on his back for 12 hours and drink a lot of water to prevent clot formation.
- · Retroperitoneal haemorrhage
- · Hematuria
- · Pain in loins.
This is small description about liver, renal, abdo men biopsy, etc.