A liver biopsy (BI op see) is the removal of a tiny piece of tissue from the liver to be examined under a microscope. This test is done to find the cause or to follow the course of liver disease. Your child will be admitted to Nationwide Children’s Hospital through either the Patient Admitting Department or the Procedure Center. He or she will spend one night in the hospital after the test.
Instructions if your child is admitted through the Procedure Center the day of the liver biopsy:
- Blood tests need to be completed a few days before the procedure on _____________. If you cannot get the necessary lab tests done before the procedure the biopsy may have to be cancelled.
- Blood tests can be collected at any of the Nationwide Children’s Hospital (NCH) Close to Home Lab locations. If you cannot have blood tests done at an NCH Close-to-Home location, they can be collected at any lab of your choice. Please let the Liver Center know what lab you will be using so we can send orders.
- Please bring your child to the Crossroads Registration located on the 1st floor along the Blue Path in the main hospital.
Instructions if your child is admitted through the Patient Admitting Department the day of the liver biopsy:
- Blood tests will be done when your child is admitted. An IV (intravenous) line will be inserted to prepare for the test.
- Please bring your child to the Admitting Department located on the 1st Floor along the Blue Path in the main hospital.
Night Before and Day of the Test
Your child will have general anesthesia for this procedure. It is very important to follow these instructions exactly:
- Your child may have breast milk up to 4 hours and formula up to 6 hours before the procedure. All other semi-liquids (liquids that you cannot see through EXCEPT for formula or breast milk) and solid foods MUST BE STOPPED 8 hours before the procedure.
- Your child may have clear liquids up to 4 hours before the procedure. After that, he or she may have nothing else to drink. Clear liquids are those you can see through that have no pulp or food bits in them. Examples of clear liquids are water, apple juice, white grape juice and Pedialyte®.
- Gum, cough drops and hard candy are not allowed. If your child has been chewing gum, the procedure will be delayed 4 hours from the time the gum is spit out. If the gum has been swallowed, the procedure will be delayed 6 hours from the time it was swallowed.
- Any female who is menstruating or is 12 years of age or older will have a urine pregnancy test at the hospital on the day of the test.
- A parent or legal guardian must be present to give consent for the test and for the sedation or anesthesia. If a parent or legal guardian is not available, please provide a phone number where a nurse and doctor can reach them at the time of the test.
- The test usually takes 30 minutes or more to complete. Parents may wait in the Radiology lobby until the test is over.
How the Test is Done
- The test is done in Interventional Radiology.
- Your child will be connected to monitors. This will let the nurse and doctor check the child’s heart rate, breathing, and blood pressure during the test.
- Your child will have general anesthesia for this test and will be completely asleep. He or she must be very still for this procedure.
- Once your child is asleep, his or her arms will be placed over the child’s head.
- The doctors and technologists will wear gloves, gowns and face masks during the test.
- The doctor will clean your child’s right side with a disinfectant liquid.
- An ultrasound scan of the liver will be done to find a good place to do the biopsy. Then the doctor will inject a small amount of numbing medicine into a spot on the child’s right side. The doctor will use a long, thin needle to take a tiny piece of tissue from the liver. This sample will be sent to the lab to be examined under a microscope.
- A bandage will be put on tightly over the biopsy site and taped securely in place.
After the Test
- Following the biopsy, your child will go to the recovery room. After recovery from anesthesia, a nurse will take the child back to his or her own room. Your child’s heart rate and blood pressure will be checked frequently for several hours after the procedure, both in the recovery room and in your child’s hospital room.
- Blood will be drawn after the test, and sometimes again the next morning.
- Your child must stay in bed lying down for 4 hours (Picture 1), except to use the bathroom.
- The nurse may prop your child on his or her right side with a pillow behind the back. This position helps put pressure on the biopsy site to prevent bleeding. However, lying on the back and lying on the right side are both acceptable positions for the hours of recovery.
- Your child will be sleepy for a while. At least four hours after the procedure, if your child is stable and fully awake, the vital signs are stable and the blood tests have come back normal, he or she will be able to get up and out of bed, and also to drink liquids and then have regular foods.
- The doctor will come to see your child the next morning. If there are no other tests ordered, your child may go home.
Treatment at Home
The pain from a liver biopsy should be mild and usually occurs in the area of the biopsy or in the right shoulder. This can be treated with acetaminophen (Tylenol®). Continue to give your child his or her other prescribed medicines.
For 3 days after the biopsy your child should follow these directions:
- Do not lift heavy objects (no heavier than 10 pounds for adults).
- Do not take non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen (Motrin® or Advil®) or naproxen (Naprosyn® or Aleve®).
- Drink plenty of fluids.
- Wash the biopsy site gently and pat dry. Do not scrub the site.
For 7 days after the biopsy your child should follow these directions:
- Do not play sports, especially baseball (risk of getting hit by the ball) or contact sports such as football, soccer, hockey and basketball. Avoid any other activity that poses a risk for hard hits to the abdomen.
- Do not take part in activities that shake the abdomen, like running, jogging, tennis, aerobics and playing on a trampoline.
We will not have liver biopsy results before your child goes home. The doctor will talk with you about the biopsy results and plan of care for your child at the follow-up appointment that is scheduled 1 to 2 weeks after the biopsy.
If you have any questions or concerns, please call the Nationwide Children’s Hospital Liver Center at (614) 722-8406.
HH-III-22 4/79, Revised 2/19 Copyright 1979, Nationwide Children’s Hospital