title: Endoscopic ultrasound-guided liver biopsy in pediatric patients.
abstract: Endoscopic ultrasound (EUS) is routinely used for diagnostic and therapeutic purposes in adults, and there is emerging literature on its feasibility and safety in children. A recent novel application is EUS-guided liver biopsy (EUS-LB), which has shown to be technically simple, safe, and provides adequate diagnostic yield in adults for evaluation of liver disease; but the use of EUS-LB has never been evaluated in the pediatric population. We report the first case series of EUS-LB in the pediatric population, performed on 3 children, 1 girl and 2 boys-ages 9, 14 and 17 respectively, using a 19-gauge EUS-fine needle aspiration needle. All three cases were performed for the evaluation of unexplained elevated liver enzymes, with above-average diagnostic yield and without any immediate or delayed complications in all children. The use of EUS-LB was pivotal in the management of all the cases. Our case series illustrates the diagnostic utility and safety of EUS-LB in pediatric patients.
authors.affiliation: Department of Gastroenterology, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors.forename: Amitpal S
authors.initials: AS
authors.lastname: Johal
authors.affiliation: Department of Gastroenterology, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors.forename: Harshit S
authors.initials: HS
authors.lastname: Khara
authors.affiliation: Department of Pediatric Gastroenterology, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Maksimak
authors.affiliation: Department of Gastroenterology, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Diehl
keywords: Abnormal liver enzymes; endoscopic ultrasound; liver biopsy; liver disease; pediatric patients