X-Ray & Sono Guided Procedures
A liver biopsy is a procedure to remove a small piece of the liver so it can be examined with a microscope for signs of damage or disease.
Pleural Effusion Aspiration
Also known as pleural fluid analysis, thoracentesis is a procedure that removes fluid from the chest through a needle or tube.
- To investigate the cause of pleural effusion:
The British Thoracic Society guidelines suggest that pleural aspiration should be reserved for the investigation of unilateral exudative pleural effusions. It should not be carried out if a unilateral or bilateral transudative effusion is suspected, unless there are atypical features or there is failure of response to therapy.
- As symptom relief for breathlessness:
Repeated 'tapping' of fluid may be useful in palliative care. However, there is a high recurrence rate if pleurodesis (intrapleural instillation of a sclerosant) is not carried out simultaneously.
Relative contra-indications to pleural effusion aspiration
- Very small volume of fluid.
- Bleeding diathesis.
- Anticoagulant therapy.
- Mechanical ventilation (increased likelihood of tension pneumothorax or bronchopleural fistula if the lung is punctured).
- Cutaneous disease over the proposed skin puncture site.
Ascites is found elsewhere, including the medical management. Tapping of ascites is a simple technique that can be used for diagnostic or therapeutic purposes. For the cancer patient, it is primarily palliative but in cirrhosis it can serve as an important bridge in the wait for a liver transplant.
- New onset ascites
- To determine aetiology.
- To differentiate transudate versus exudate.
- To detect cancerous cells.
- Suspected spontaneous or secondary bacterial peritonitis.
- To relieve respiratory distress secondary to ascites.
- To relieve abdominal pain or pressure secondary to ascites.