Needle biopsy of the liver

There are blind and sight (under the control of the laparoscope) methods biopsy. The first convenient and generous with diffuse lesions P., the second method, is set in the presence of focal lesions of the authority. The most used needles are needle Mangini, as well as its modification proposed by A. F. Blogerom and M. P. Sinelnikovo.
When evaluating the data puncture biopsy should be remembered that the correlations between the individual clinical symptoms, the indices of functional state of the liver and its morphological changes are relative and are not strictly regular character. Practically important is the use of needle biopsy for differentiation-jaundice in cases where the origin of jaundice remains unclear.
This method is valuable for recognition bestellung, latent flowing forms of the epidemic hepatitis, as well as its outcomes (relapses, persistent forms, fibrosis, chronic hepatitis, and so on).
The method of puncture biopsy is set in the progressive recognition of cirrhosis in whom the clinical diagnosis is not clear, and to explain unclear gepato - and splenomegaly. Congenital fibrosis P., tumors P., reticuloendothelial diseases are also an indication for biopsy.
Using histochemical methods of punctate liver possible to determine its various enzymes. Electron microscopy increases the possibility of studying of structural changes in the biopsy material P.
Technique blind puncture biopsy. Aspiration puncture is made in the IX-th intercostal space on the right anterior axillary line (together the greatest hepatic stupidity). The stiletto pierce the skin and the muscles in the hole needle to puncture (type Mangini), stands on the syringe. The puncture is made in a moment of inspiration. Dipping the needle into the liver, syringe create a vacuum and aspiritual a piece of cloth. After the puncture the patient during the day comply with bed rest, avoid hot meals.
Contraindications liver punctures are prolonged mechanical jaundice, hemorrhagic syndrome, suspected abscess and plenty of ascites.