Liver biopsy

Also known as: Biopsy - liver and Percutaneous biopsy

Definition

A liver biopsy is a test that takes a sample of tissue from the liver for examination.

How the test is performed

The test is usually done in the hospital. Before the test is done, you may be given a medicine to prevent pain or to calm you (sedative).

If the biopsy is done through the abdominal wall, you will be lying on your back with your right hand under your head. It is important to be as still as possible.

The health care provider will determine the correct spot for the biopsy needle to be inserted into the liver. The skin will be cleansed, and a small needle will be used to to inject medicine to numb the area. A small cut is made, and the biopsy needle is inserted. Ultrasound is usually used to guide the needle.You will be told to hold your breath while the biopsy is taken. This is to reduce the chance of puncturing the lung or tearing the liver.

The needle is removed quickly. Pressure will be applied to stop the bleeding. A bandage is placed over the insertion site.

The procedure can also be done by inserting a needle into the jugular vein. If the procedure is performed this way, you will lie on your back. X-rays will be used to guide the health care provider to the vein. A special needle and cathether (thin tube) is used to take the biopsy sample.

If you receive sedation for this test, you will need someone to drive you home.

How to prepare for the test

Tell your health care provider about:

• Bleeding problems
• Drug allergies
• Medications you are taking
• Whether you are pregnant

You must sign a consent form. Blood tests are sometimes done to test your blood's ability to clot. You will be told not eat or drink anything for the 8 hours before the test.

For infants and children:

The preparation you can provide for this test depends on your child's age and experience. For specific information regarding how you can prepare your child, see the following:

• Infant test or procedure preparation (birth to 1 year)
• Toddler test or procedure preparation (1 to 3 years)
• Preschooler test or procedure preparation (3 to 6 years)
• School age test or procedure preparation (6 to 12 years)
• Adolescent test or procedure preparation (12 to 18 years)

How the test will feel

You will feel a stinging pain from the anesthetic needle and when the anesthetic is injected. The biopsy needle may feel like deep pressure and dull pain. Some people feel this pain in the shoulder.

Why the test is performed

The biopsy helps diagnose many liver diseases. The procedure also helps assess the stage (early, advanced) of liver disease. This is especially important in hepatitis C infection.

The biopsy also helps detect:

• Cancer
• Infections
• The cause of abnormal levels of liver enzymes that have been found in blood tests
• The cause of an unexplained liver enlargement

Normal Values

The liver tissue is normal.

What abnormal results mean

The biopsy may reveal a number of liver diseases, including cirrhosis, hepatitis, or infections such as tuberculosis. It may also indicate cancer.

This test also may be performed for:

• Alcoholic liver disease (fatty liver, hepatitis, or cirrhosis)
• Amebic liver abscess
• Autoimmune hepatitis
• Biliary atresia
• Chronic active hepatitis
• Chronic persistent hepatitis
• Disseminated coccidioidomycosis
• Hemochromatosis
• Hepatitis B
• Hepatitis C
• Hepatitis D
• Hepatocellular carcinoma
• Hodgkin's lymphoma
• Non-alcoholic fatty liver disease
• Non-Hodgkin's lymphoma
• Primary biliary cirrhosis
• Pyogenic liver abscess
• Reye syndrome
• Sclerosing cholangitis
• Wilson's disease

What the risks are

• Collapsed lung
• Complications from the sedation
• Injury to the gallbladder or kidney
• Internal bleeding

References

Lomas DJ. The liver. In: Adam A, Dixon AK, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 35.

Liver. Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:section IX.

See also:

• Disease

  Hepatitis

  

  Hepatitis is swelling and inflammation of the liver. It is not a condition, but is often used to refer to a viral infection of the liver.

• Disease

  Alcoholic liver disease

  

  Alcoholic liver disease is damage to the liver and its function due to alcohol abuse. See also:

• Disease

  Delta agent (Hepatitis D)

  

  Delta agent is a type of virus called hepatitis D that causes symptoms only in people who also have a infection.

• Disease

  Hodgkin’s lymphoma

  

  Hodgkin’s lymphoma is a cancer of lymph tissue found in the lymph nodes, spleen, liver, bone marrow, and other sites.

• Disease

  Wilson's disease

  

  Wilson’s disease is an inherited disorder in which there is too much copper in the body’s tissues. The excess copper damages the liver and nervous system.

• Disease

  Liver disease

  

  The term “liver disease” applies to many diseases and disorders that cause the liver to function improperly or stop functioning. Abdominal pain, yellowing of the skin or eyes (), or abnormal results of suggest you have liver disease. See also:

• Disease

  Reye syndrome

  

  Reye syndrome is sudden (acute) brain damage (encephalopathy) and liver function problems of unknown cause. The syndrome has occurred with the use of aspirin to treat chickenpox or the flu in children. However, it has become very uncommon since aspirin is no longer recommended for routine use in ...

• Disease

  Cirrhosis

  

  Cirrhosis is scarring of the liver and poor liver function. It is the final phase of chronic .

• Disease

  Sclerosing cholangitis

  

  Sclerosing cholangitis refers to swelling (inflammation), scarring, and destruction of the ducts inside and outside of the liver.

• Disease

  Autoimmune hepatitis

  

  Autoimmune hepatitis is inflammation of the liver that occurs when immune cells mistake the liver’s normal cells for harmful invaders and attack them.

• Disease

  Hepatocellular carcinoma

  

  Hepatocellular carcinoma is cancer of the liver.

• Disease

  Non-Hodgkin's lymphoma

  

  Non-Hodgkin’s lymphoma is cancer of the lymphoid tissue, which includes the lymph nodes, spleen, and other organs of the immune system.

• Disease

  Pulmonary tuberculosis

  

  Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs, but may spread to other organs.

• Disease

  Hepatitis C

  

  Hepatitis C is a viral disease that leads to swelling (inflammation) of the liver.

• Disease

  Amebic liver abscess

  

  Amebic liver abscess is a collection of pus in the liver brought on by an intestinal parasite.

• Disease

  Hemochromatosis

  

  Hemochromatosis is a disorder that results in too much iron being absorbed from the gastrointestinal tract.

• Disease

  Biliary atresia

  

  Biliary atresia is a blockage in the tubes (ducts) that carry a liquid called bile from the liver to the gallbladder. The condition is congenital, which means it is present from birth.

• Disease

  Primary biliary cirrhosis

  

  Primary biliary cirrhosis is irritation and swelling (inflammation) of the bile ducts of the liver, which blocks the flow of . This obstruction damages liver cells and leads to scarring called cirrhosis.

• Diarrhea - what to ask your doctor - child

  Diarrhea is when your child has more than two very loose bowel movements in 1 day. For many children, diarrhea is mild and will pass within a few days. For others, it may last longer. It can make you feel weak and dried out (dehydrated). It can also lead to unhealthy weight loss. A stomach or ...

• Disease

  Pyogenic liver abscess

  

  Pyogenic liver is a pus-filled area in the liver.

• Disease

  Coccidioidomycosis - disseminated

  

  Disseminated coccidioidomycosis is a fungal infection that spreads through the bloodstream and involves many organs.

Review date:

January 10, 2011

Reviewed by:

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Copyright Information

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.