RE: *TINA* Transjugular Biopsy

[Guest guest]

Hi Tina,

My son Ken had a

transjugular biopsy in 1999 at Baylor in Dallas. Our local GI at the time said only “experienced

doctors” should perform this kind of biopsy, so he referred us to Baylor.

Our experience was: the

biopsy itself went fairly fast – in fact took less time than the paper

work before hand. It was almost

totally painless. No follow-up was needed;

Ken was released

to go home in short order (I can’t remember how long it took, but know

there was no lying on your side for hours). While the sample of liver tissue was

small, it was enough to diagnosis Ken with

stage 4 cirrhosis. If I remember correctly

Ken had to

fast for several hours before hand, he was sedated during the procedure and had

to remain sitting up for an hour afterwards, which was no problem for us as we

had a 2 hour ride home. Ken said

the whole thing was a snap and would do it again in a heart beat.

I’ve sent you 2

articles on T.J.B. below. One is a short paragraph, the other a study.

HTH.

Good Luck, please let us know how things go for Bill,

Barb

in Texas - Son Ken

(30) UC 91 & PSC 99

1. Transvenous or transjugular liver biopsy may be

performed by a radiologist in special circumstances, e.g. when the patient has

a significant problem with blood clotting (coagulopathy)

or a large amount of fluid within the abdomen (ascites). For this reason,

transjugular liver biopsy is recommended for patients with advanced cirrhosis.

With this procedure, a small tube is inserted into the internal jugular vein in

the neck and radiologically guided into the hepatic

vein, which drains the liver. A small biopsy needle is then inserted through

the tube and directly into the liver to obtain a sample of tissue.

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2. AJR Am J Roentgenol.

2003 Jan.

Transjugular

biopsy of the liver in pediatric and adult patients using an 18-gauge automated

core biopsy needle: a retrospective review of 410 consecutive procedures.

TP, Presson

TL, Heneghan MA, JM.

Department of Radiology, Rm. 1502, Duke University Medical

Center, Box 3808, Durham, NC 27710, USA.

OBJECTIVE: The aim of our study was to evaluate the safety and efficacy of

transjugular biopsy of the liver in a large population of patients using an

18-gauge automated core biopsy needle. MATERIALS AND METHODS: A total of 371

patients underwent 410 attempted transjugular biopsies of the liver during an

80-month period. Data collected included the retrospective review of patients'

computerized medical records, clinical charts, and nursing documents. Patient

demographic data, indications for liver biopsy, laboratory findings of

coagulation values, procedural data including number of needle passes

performed, and histologic description of the

specimens were noted. Indications varied and included traditional

contraindications to the percutaneous approach such

as coagulopathy (53%) and ascites (29%). In one

patient, the hepatic veins could not be catheterized because of angulation with the inferior vena cava, and in one patient,

biopsy was performed using the femoral route because of occlusion of the

jugular vein. All patients were followed up for a minimum of 24 hr after the

procedure to determine complications. RESULTS: The mean number of needle passes

per procedure was 3.4 (range, 0-18). Hepatic tissue was obtained in 409

procedures via the venous route (408 transjugular and one transfemoral),

and a tissue diagnosis was achieved in 403 (98%). The six tissue samples were nondiagnostic because they were too small (n = 3) or too

fragmented (n = 1) or because they did not contain hepatic tissue (n = 2). Ten

complications (2.4%) occurred, including three intraperitoneal

hemorrhages that resulted in one death. CONCLUSION: Transjugular biopsy of the liver using an automatic core biopsy needle

is safe and produces adequate tissue specimens in a high percentage of

patients.

PMID: 12490497 [PubMed - indexed

for MEDLINE]

-----Original Message-----

From: Tina Rampino

They are planning to do a biopsy but since there is so much fluid in his abdomen,

they want to do a

juggular biopsy. Has anyone ever heard of this?