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 when your child is admitted. An IV (intravenous line) 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 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 semi-liquids 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.
- 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 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 (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 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 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 your child is stable enough to return to his or her 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 or she has recovered from anesthesia, the nurse will take the child back to the room.
- Blood will be drawn on the evening of the test, and sometimes again the next morning.
- Your child must stay in bed lying down for 4 hours (Picture 2), except to use the bathroom. 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 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.
- 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 or she will be able 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.
- 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 1-2 weeks after the biopsy.
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 3 days after the biopsy your child should follow these directions:
- Do not play contact sports or take part in any 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.
- 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®, Advil®) or naproxen (Naprosyn®, Aleve®).
- Drink plenty of fluids.
- Wash the biopsy site gently and pat dry. Do not scrub the site.
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 8/18 Copyright 1979, Nationwide Children’s Hospital