title: Sonographically guided percutaneous liver biopsy in infants: a retrospective review.
abstract: OBJECTIVE
  The purpose of our study was to assess the technical success and complication rate of sonographically guided percutaneous liver biopsies performed in infants under 1 year old at a tertiary pediatric center.
  
  
  METHODS
  Retrospective analysis of 65 biopsies performed in 61 infants between January 1999 and December 2003 was conducted. Data collected included patient demographics; details of the biopsy procedure including indication, needle type and size, number of passes, and samples; pathology results; and procedure-related complications.
  
  
  RESULTS
  The 61 infants studied included 37 males and 24 females with a mean age of 119 days (age range, 7-348 days; median age, 83 days) and a mean weight of 4.5 kg (1.9-8.3 kg). A total of 65 biopsies were performed in these 61 infants. General anesthesia was used in 66.1% of procedures. An 18-gauge needle was used in 47 (72.3%) procedures. Coaxial technique was used in seven procedures, and five biopsy tracts were embolized. In 63 of 65 procedures, the mean number of passes was 1.8. In two procedures, using a coaxial technique, 11 and 12 passes were made. One biopsy was considered technically unsuccessful, and 64 of 65 (98.5%) of the biopsies provided adequate tissue for pathologic analysis. There were three (4.6%) major complications related to bleeding: one requiring a blood transfusion, one requiring surgery, and one arteriobiliary fistula requiring transarterial embolization. Three (4.6%) minor complications also occurred. There were no deaths.
  
  
  CONCLUSIONS
  Sonographically guided percutaneous liver biopsy in infants is a good and effective diagnostic tool. The complication rate, however, even when performed by an experienced physician, is not insignificant in this age group of patients.
authors.affiliation: Department of Diagnostic Imaging, Image Guided Therapy Centre, The Hospital for Sick Children, 555 University Ave., Toronto, ON M5G 1X8, Canada. joao.amaral@sickkids.ca
authors.forename: Joao Guilherme
authors.initials: JG
authors.lastname: Amaral
authors.forename: Jordan
authors.initials: J
authors.lastname: Schwartz
authors.forename: Peter
authors.initials: P
authors.lastname: Chait
authors.forename: Michael
authors.initials: M
authors.lastname: Temple
authors.forename: Philip
authors.initials: P
authors.lastname: John
authors.forename: Charles
authors.initials: C
authors.lastname: Smith
authors.forename: Glenn
authors.initials: G
authors.lastname: Taylor
authors.forename: Bairbre
authors.initials: B
authors.lastname: Connolly
mesh_terms: D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000473:pathology*; D008297:Male; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional