Liver Biopsy.

[William55]

Hello. Got letter yesterday from Hospital date for Liver Biopsy is Monday 12th September at 2pm. Got to report to the Hospital on the morning at 7.30am to have my bloods done. And it states in the letter that I am being admitted for overnight stay???? Could this be because I am a Type 2 Diabetic on Insulin and Tablets I wonder? So, in all I have had: Fibroscan, Abdominal Ultrasound Scan, Liver MRI Scan with Contrast and now Liver Biopsy all I have been told by Specialist is I have NAFLD.

[AyrshireK]

Have they said what type of liver biopsy you are having? Is it a through the side one or transjugular? If they are doing bloods in the morning before the procedure it might be to check on your platelet count.

When my hubby had his 2nd biopsy (by the transjugular route) he had to go in the day before so he could have bloods done and then a platelet tranfusion before his biopsy actually took place. After the biopsy he had to lay down for flat for several hours and be regularly monitored to ensure there was no internal bleeding and he was kept overnight afterwards.

The need for the overnight stay may be due to platelet count or indeed due to your diabetes issues.

Take a book or something to keep you entertained because most folks report that to be the most awkward thing about biopsy - the lengthy rest and monitoring bit.

All the best for it,

Katie

[William55 in reply to AyrshireK]

Hi. Thanks for your reply. I am having the Liver Biopsy done by needle inserted between ribs on my side. I just don't understand why I am having a Liver Biopsy? I've had Fibroscan, Abdominal Ultrasound and MRI Liver Scan with Contrast dye only to be told I might have NAFLD - which is common with T2 Diabetics. I don't drink Alcohol or Smoke and I am a Veggie. I do however have Ascites off the abdomen and taking Diuretics, and do I itch over my body. I am hoping that the Liver Specialist tells me exactly if anything is found? Thanks.

[AyrshireK in reply to William55]

Although they've said it is NAFLD they are obviously looking to confirm the level of damage and perhaps also the diagnosis - they need to look at the liver at a cellular level to see exactly what is going on.

Pin your specialist down and ask for his definite diagnosis - have they said if you have cirrhosis or not ? Because ascites tends to be a symptom of cirrhosis rather than early stages of liver disease. The pruritis or itching if it's due to a bilirubin build up can also be a symptom of cirrhosis but it can also be indicative of bile duct issues within the liver so it might be another thing they are investigating.

When my hubby was first diagnosed it was done by his presentation of advanced cirrhosis symptoms, blood tests, an ultrasound and biopsy. All done within his first week of hospital admission. His liver consultant redid the biopsy (by transjugular route) a couple of years later to check on matters.

Hope you get some proper answers after your biopsy.

Katie

[William55 in reply to AyrshireK]

Hello Katie, I Thank You Very Much for your reply. From what I have read on various sites about ascites and I agree with you that this is more to do for Cirrhosis - which Is Why I am baffled to having had all these tests. I only began 3 months ago taking Diuretics because I fractured my knee cap and my leg swelled up with fluid due to been told to elevate it. By the end of the day my stomach is swollen (I look pregnant!) And my right leg is twice the size from ankle to kneecap. On a morning when I get up my stomach is flat and leg no fluid, it's as the day progresses the fluid builds. I take blood pressure tablets and Forusemide and I wee all day long.

When I have got to see/speak to the Consultant - I'll put an update on here. Thank You once again. William

[fisherking1 in reply to William55]

The itching can be lessened with ultraviolet light treatment, and or cholostyramine powder , which is primarily recommended for high cholesterol but also binds the bile acids in the liver and sends them out the gut. Best wishes. Cold showers and calamine lotion also work well.

[fisherking1 in reply to AyrshireK]

They administer procaine the proximal area the needle will enter so you will only feel pressure. Once inside the Pathologist will be able to see the needle and the liver and then you will feel a burning sensation as the needle penetrate the capsule into the parenchyma (functional organ tissue). Then you will hear a loud click and this is the sound of the Pathologist snipping a tissue sample for the Histologist to analyse. Since the liver tissue is extremely vascular some bleeding will occur that's why you had the clotting factors checked especially the platelet count. Then the needle is withdraw and the same is placed in saline and rushed to Histology lab. Rest relax ask for a shot of demerol and wait for monitoring nurse to check vital signs for 3 hours. You are required to have someone pick you up or you will not be discharged for concerns other than liability. Best wishes.

By the way what symptoms did you present to warrant this invasive procedure in the first place.

Take care.

[William55 in reply to fisherking1]

Hi Drpeter, Firstly Thank You for your reply. I am shocked to be quite honest with it all!! My LFT have been 'abnormal' for a few years now, so I had a Fibroscan done in February and told my result was graded 10. Saw Liver Specialist in June he says I have Fibrosis, (NAFLD), did a load of Blood tests. Then get letter late June to have Abdominal Ultrasound Scan, got letter early July they think? I have blockage to Liver Artery, so had Liver MRI Scan with Contrast dye in late July. Got letter mid August to say he (Liver Specialist) needs to know the extent of the fatty Liver and so attend on Monday 12th September for Liver Biopsy with overnight stay in hospital. I have only seen the Liver Specialist ONCE and yet had all these tests done. It was my GP who put me on the Furosemide and told me I have Ascite, and constant itching - he prescribed Loratidine. He said it could well be Cirrhosis of the Liver??? And the Biopsy will tell the Specialist what he needs to know. I have to add that I do not drink Alcohol or Smoke. William.

[Dulux]

I was in overnight, in fact did night before as well as I'm a fair way from the hospital and they put me on a drip the night before.

I had a cyst aspiration done at the same time, I think they took 4 biopsy samples, done with local anesthetic using ultra sound for guidance, front of chest, I watched the whole thing as I'm not bothered by that sort of thing.

It's not particularly painful, you'll be sore for a couple of days though.

[LAJ123]

Dulux said its not painful. Which is mostly true, but if you are particularly anxious you can ask for sedation. I've had both routes and sedated both times. The guided needle route - I had no memory just woke feeling fine in recovery. Transjugular was sedated but I was aware and had a good memory. The surface anaesthetic worked well so I didn't feel the introduction of the line. Bottom line is - nothing to worry about.

Jim

[annew272]

Hello, I had a biopsy done in December and was terrified leading up to the proceedure. I am type 2 diabetic and was on a lot of insulin when I had the biopsy, attended first thing, about 7.30 from memory and stayed till 6pm, had the biopsy at about 10.30ish. The local anaesthetic was a bit sore going in and the two samples they took caused a small amount of pain, I didnt suffer too much pain afterwards. People havent mentioned it yet, the worst bit for me was staying in bed, the first two hours on my right side and then the next 4 hours I was allowed on my back but not allowed out of bed, not even for the toilet had to use a bed pan for the first time in my life.

I had an ultrasound and Fibroscan and the doc kept changing his mind about the need for a biopsy but then some of my blood results changed and he thought there was a risk of an autoimmune issue so did the biopsy. My fibroscan was 37.4 and I was diagnosed prior to biopsy as having compensated Cirrhosis, the biopsy came back showing no conclusive signs of Cirrhosis but it was decided that with the other results this was how I would be treated.

Thankfully due to lifestyle changes all my results are improving showing that my liver is improving.

Anne

[dckimberly]

Staying in overnight is completely normal. You may need a bag of blood, of platlettes. I would not worry, at all. Also, you will have to lay on both sides and your back for a certain amount of time after the proceedure. I've had two done, both trans jugular. It really does not hurt per say, but there is some pressure.

If they have not given you a complete diagnosis, it sounds like they are running the gambit of tests many of us have, prior to a full diagnosis and treatment plans are put into place. They like to check everything. They had me in hospital twice overnight and then an all day trip in hospital before they would actually say what I had, Hep C, fatty liver and alcoholic cirhossis, with a decompensated liver, showing with symptoms of ascites, etc.

I know it's hard, but try not to worry and have a notebook, a fresh one, with questions and concerns for the consultants. Write down every proceedure and outcome, all your medications, and when they change, etc. then use that notebook for everything. You will have it all in one place.

Cheering you on!

Kimberly