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.
Before the test
- Your child will be admitted to the hospital the morning of the liver biopsy. He or she will spend one night in the hospital.
- Blood tests will be done upon admission. An IV will be inserted to prepare for the test.
Your child will have general anesthesia for this procedure. It is very important to follow these instructions exactly:
- Your child may have CLEAR LIQUIDS up to 4 hours before the procedure. After that, he 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®.
- Your child may have breast milk up to 4 hours and formula up to 6 hours before the procedure and water or Pedialyte® up to 4 hours before the procedure. All other liquids, semi-liquids and solid foods MUST BE STOPPED 8 hours before the procedure.
- 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.
If the procedure is postponed more than 1 hour, your child will be allowed clear liquids. Afterward, the 4-hour time before the procedure will begin again.
- 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 about 30 minutes 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 his heart rate, breathing, and blood pressure during the test.
- Your child will have general anesthesia for this test and be completely asleep. He must be very still for this procedure.
- Once your child is asleep, his arms will be placed over his head (Picture 1). 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 brown 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 nurse will be with your child during the test and will check his or her heart rate and blood pressure often after the test. These checks will be done until he is stable enough to return to his room. After the biopsy, a bandage will be put on tightly over the biopsy site and taped securely in place.
After the test
- After the biopsy your child will go to the recovery room. Once he has recovered from anesthesia, the nurse will take him back to his room.
- Blood will be drawn on the evening of the test and again the next morning.
- Your child must stay in bed lying down for 4 hours (Picture 2). He will need to use the bedpan or urinal instead of the bathroom during this time. After 4 hours, if the blood tests are normal, your child will be allowed to get out of bed.
- The nurse may prop your child on his right side with a pillow behind his back. This position helps put pressure on the biopsy site to prevent bleeding.
- The nurse will continue to check your child’s pulse and blood pressure often.
- Your child will be sleepy for a while. At least four hours after the procedure, if your child is stable and fully awake, he will be able to 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.
- The doctor will talk with you about the plan of care for your child and will tell you when to call for biopsy results.
Treatment at home
The pain from a liver biopsy should be minimal 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 7 days after the biopsy your child should follow these directions:
- No contact sports or blows to the abdomen.
- No activities that shake the abdomen, like running, jogging, tennis, aerobics and playing on a trampoline.
- Drink plenty of fluids.
- Wash the biopsy site gently and pat dry. Do not scrub the site.
- Do not lift heavy objects (no heavier than 10 pounds for adults).
- Do not take non-steroidal anti-inflammatory drugs (NSAIDS) like aspirin or ibuprofen.
To get the biopsy results or if you have any questions or concerns, please call the Nationwide Children’s Hospital GI Department at (614) 722-3450.
HH-III-22 4/79, Revised 3/17 Copyright 1979 Nationwide Children’s Hospital