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Learn About Conditions and Procedures

What is Trauma?

Trauma is a serious injury or shock to the body. It is caused by a physical force such as violence or an accident. The injury may be complicated by psychiatric, behavioral, and social factors.

It is critical to have an entire team immediately available to provide care to an injured patient 24-hours a day. This teamwork starts at the scene of the injury where a coordinated, statewide pre-hospital medical system rapidly transports the injured patient from the scene to the hospital providing the appropriate level of care according to criteria established in the statewide trauma regulations. Once at the hospital, a complete team of surgeons, emergency physicians and nurses continue the life-saving treatment.

This team approach to care of the injured patient has had a dramatic impact on saving lives.

Minimally Invasive Procedures for Massive Bleeding

Injuries take many forms. The most advanced hospitals can treat injuries with a variety of approaches that involve well-known ones, like surgery, and newer ones where minimally invasive procedures can replace some surgeries.

As a Level 1 Trauma Center, Hartford Hospital has Interventional Radiologists as part of the Trauma Team. They perform procedures such as "embolization" which is a recognized interventional radiology technique that is used to treat trauma patients with massive bleeding.

Click here to see some of the advanced interventional techniques available at Hartford Hospital.

Learn more about trauma, or search below to learn about other health conditions.

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Liver Biopsy

(Biopsy of Liver)

by Daus Mahnke, MD

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

This is a procedure to obtain a sample of your liver tissue.

Reasons for Procedure

Biopsies of the liver are usually done to evaluate:

Abnormal blood tests (eg, elevated liver enzymes, elevated copper, or iron in the blood)
An enlarged liver
The severity of liver diseases
The progress of therapy for liver diseases
A liver mass
The liver after a liver transplant

Possible Complications

If you are planning to have a liver biopsy, your doctor will review a list of possible complications, which may include:

Pain (common)
Bleeding (uncommon)
Infection (rare)
Perforation of the gallbladder or intestines (rare)
Puncture of the lung (rare)

Factors that may increase the risk of complications include:

Smoking

What to Expect

Your doctor may do the following:

Physical exam
Blood tests
Ultrasound—a test that uses sound waves to examine the liver

Before your biopsy:

Avoid eating or drinking for 8-12 hours.
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Anti-inflammatory drugs (eg, aspirin )
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
Arrange for someone to drive you home after the biopsy.

Local anesthesia—just the area that is being operated on is numbed; given as an injection and may also be given with a sedative

There are different techniques to do a liver biopsy, including:

Conventional liver biopsy
Laparoscopic liver biopsy (done when the biopsy needs to be taken from a very specific area of the liver)
Transvenous liver biopsy (done if your blood clots poorly or you have a lot of fluid in your abdomen)

You will lie on your back with your right hand behind your head. The doctor might use an ultrasound or CT scan to help guide the placement of the needle. The skin will be cleaned. Next, the doctor will inject medicine to numb the area. The doctor will make a small incision. You will need to exhale and hold your breath while the needle is inserted. Sometimes, the needle will need to be inserted several times. After the procedure, your doctor will bandage the area. You will lie on your right side for at least two hours.

Placement of Liver Biopsy Needle

Your doctor will make a tiny incision. She will pass a long tool with a camera on the end into your abdomen in the area of the liver. The scope will send images of the liver to a TV screen. Your doctor will make other incisions to pass other tools. With these tools, she will remove samples of the liver.

Your doctor will thread a tiny flexible tube into a vein in your neck or groin. This tube will be threaded all the way into the veins in your liver. Your doctor will pass a biopsy needle through the tube to get a biopsy sample.

You will lie on your right side for at least two hours.

About 15-20 minutes

You will have mild pain or cramping at the biopsy site. You may also have pain in the right shoulder. The pain should last for less than 30 minutes.

When you return home after the procedure, do the following to help ensure a smooth recovery:

If a sedative was given, do not drive for at least 24 hours.
Rest the remainder of the day.
Do not exercise or lift heavy objects for at least a week. Ask your doctor when you can resume normal activities.
Eat your normal diet.
Ask your doctor when you can resume taking your medicines.
Ask your doctor about when it is safe to shower, bathe, or soak in water.
Be sure to follow your doctor's instructions .

The results will take 1-4 weeks. You and your doctor will discuss the results.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
Severe abdominal pain, nausea, or vomiting
A faint or light-headed feeling
Severe shoulder pain
Trouble breathing, cough, or chest pain

In case of an emergency, call for medical help right away.

American Liver Foundation

http://www.liverfoundation.org/

National Digestive Diseases Information Clearinghouse

http://digestive.niddk.nih.gov/

Canadian Liver Foundation

http://www.liver.ca/

Health Canada

http://www.hc-sc.gc.ca/index_e.html/

Feldman M, Friedman LS, Sleisenger MH. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 8th ed. St. Louis: Mosby, 2005.

Grainger RG, Allison D, Adam A, Dixon AK, eds. Grainger and Allison’s Diagnostic Radiology: A Textbook of Medical Imaging. 4th ed. London: Churchill Livingstone, Inc; 2001.

Mettler FA. Essentials of Radiology. 2nd ed. Philadelphia: Saunders, 2005.

Sherlock S, Dooley J. Diseases of the Liver and Biliary System. 11th ed. Oxford, UK: Blackwell Science; 2002.

Yamada T. Textbook of Gastroenterology. 4th ed. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2003.

Zakim D, Boyer TD. Hepatology. 4th ed. Philadelphia, PA: Saunders; 2003.

6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

Last reviewed December 2011 by Marcin Chwistek, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.