Ameer Ahmad, Ghulam Qasim Khan Khichi, Abdul Rehman, Arshad Manan, Ahsan Afzal.
Liver biopsy as a diagnostic tool in undiagnosed chronic hepatic problems in children.
Pak Paed J Jan ;30(1):34-7.

Objective: To determine the diagnostic yield and safety of liver biopsy in undiagnosed cases of chronic hepatic problems in children. Design: Retrospective review of 50 pediatric patients who underwent closed needle liver biopsy. Place and duration of study: Paediatric unit 2, Quaid-e-Azam Medical College/ Bahawal Victoria Hospital, Bahawalpur, from Feb 2004 to March 2005 for a period of 14 months. Patients and methods: In this study, 50 cases of liver biopsies in children were included. The patients included children who were having chronic hepatic problems i.e., hepatomegaly, hepatosplenomegaly with or without jaundice or deranged liver function tests for more than 3 months duration. In these cases, etiology could not be determined by routine non-invasive laboratory investigation and liver biopsy was carried out. The record of these patients was evaluated for the histopathological findings of biopsy and post-biopsy complications. Results: Liver biopsy led to a definitive diagnosis in 90 % of cases of chronic liver disorders in children. Glycogen storage diseases are the commonest disorders present in 40% of the cases, followed by histopathological changes of fatty liver in 18%, and cirrhosis in 10% of the cases. Only 7(14%) children complained of pain at the local site during stay in the ward in the first six hours after biopsy. Conclusion: The percutaneous liver biopsy provides a good diagnostic yield with an acceptable failure rate. The approach to the management of various liver ailments can be tailored according to the histological diagnosis furnished by the liver biopsy. It is very safe with minimal complications.

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