HISTORY:
CT DOSE:
SEDATION: Monitored by the IR registered nurse or surrogate, an independent trained observer providing Moderate Sedation with fentanyl.
CONSENT: Following discussion procedure its risks benefits (including bleeding and vessel damage) and alternatives, review of readily available relevant imaging prior to the procedure informed consent was obtained witnessed and documented upon the chart. Standard presurgical timeout confirming patient procedure and when relevant side and site was performed. Any discrepancies were resolved via consultation with appropriate readily available data sources. The patient was prepared and draped in standard sterile fashion.
TECHNIQUE:
Following the careful explanation of the potential risks and benefits of the procedure, oral and written informed consent was obtained.
Conscious sedation using Versed 1mg and Fentanyl 50 mcg IV was provided by certified nursing staff after normal head/neck and cardiopulmonary exam. Patient was monitored using standard conscious sedation monitoring protocol.
Procedure was done under sterile technique and local anesthesia using 1 % lidocaine.
The target lesion was localized using CT.
17/18 gauge coaxial system was used. Two (2) 18 gauge core was obtained.
Gel foam was applied for embolization along the biopsy tract using the coax, as the needle was pulled, to decrease the risk of bleeding.
The patient tolerated the procedure well. There were no immediate complications.
IMPRESSION:
Successful CT guided core biopsy of the liver lesion.
Frequently Asked Questions
What is a CT-guided liver biopsy?
A CT-guided liver biopsy is a procedure where a tissue sample from a liver lesion is obtained using a needle, guided by computed tomography (CT) imaging. This technique allows precise targeting of the lesion to ensure an accurate diagnosis. It's often used to investigate abnormal liver findings detected during imaging studies.
How is sedation managed during a liver biopsy?
During a liver biopsy, moderate sedation is typically administered by a registered nurse or a trained observer. Medications such as fentanyl and Versed are used to ensure patient comfort while maintaining their ability to respond to instructions. Standard monitoring protocols are followed to ensure the patient's safety throughout the procedure.
What are the risks of a CT-guided liver biopsy?
The risks of a CT-guided liver biopsy include bleeding, damage to blood vessels, and infection. These risks are discussed with the patient beforehand, and informed consent is obtained. The procedure is performed under sterile conditions, and measures such as using gel foam for embolization help minimize complications.
Informed consent is crucial for a liver biopsy to ensure that the patient understands the procedure, its potential risks and benefits, and any available alternatives. It involves a discussion between the healthcare provider and the patient, and the consent is documented in the medical chart to confirm the patient's agreement.
What is the role of CT imaging in liver biopsy?
CT imaging plays a critical role in guiding the biopsy needle to the precise location of the liver lesion. It provides real-time images that help the physician accurately target the area of interest, increasing the likelihood of obtaining a representative tissue sample while minimizing risks.
How are biopsy samples collected and handled?
Biopsy samples are collected using a coaxial needle system, typically a 17/18 gauge needle, to obtain core samples of liver tissue. The samples are then preserved and sent to a lab for pathological analysis, which helps in diagnosing conditions such as liver cancer or other hepatic diseases.
What happens after a CT-guided liver biopsy?
After the procedure, the patient is monitored for any immediate complications, such as bleeding. Assuming no issues arise, the patient is usually able to go home after a short observation period. Care instructions, including activity restrictions and signs of complications to watch for, are provided upon discharge.