P1072* SAFETY OF PERCUTANEOUS LIVER BIOPSY IN OBESE CHILDREN WITH ELEVATED AMINOTRANSFERASES

Abstract

Introduction: Childhood obesity is a growing problem that has achieved national attention. Elevated aminotransferases in the obese child have been associated with non-alcoholic steatohepatitis with or without fibrosis and even cirrhosis. Liver biopsy (bx) in the obese patient has been considered unsafe due to their large body habitus. The incidence of bx associated problems in obese children has not been well established. Our aim was to evaluate the incidence of complications associated with percutaneous liver bx in obese children. Methods: The medical records of all obese children with elevated aminotransferases who underwent percutaneous liver bx at Texas Children’s Hospital from November 1, 2001 to October 31, 2003 were reviewed. Bxs were performed by one hepatologist under conscious sedation with a Jamshidi needle without ultrasound guidance. A phone call was made to the family the business day before the liver bx. Parents were asked if the patient was experiencing any problems including abdominal pain, fever, cough, vomiting or diarrhea. The business day following the liver bx another phone call was placed to the family to inquire about symptoms including abdominal pain, bleeding at the bx site, fever, vomiting and diarrhea. The family was encouraged to report any other problems and ask any questions. Results: 42 patients were identified who underwent a percutaneous liver bx and were called before and after the procedure. Of these patients, 36% were female, 83% were Hispanic with a mean age of 11.5 ± 2.8 years. The Zscore BMI was 7.3 ± 2.7. At the pre bx call, one (2%) patient with a preexisting diagnosis of chronic recurrent abdominal pain complained of abdominal pain, while twenty-eight patients (67%) reported no problems and thirteen (31%) were unable to be reached after three attempts. At the post bx call, three (6%) of the 42 patients reported problems. One, reported pain at the bx site; the patient with chronic recurrent abdominal pain reported abdominal pain again; the third patient reported soreness at the bx site that was not considered pain. Thirty patients (71%) reported no problems after the bx. After three attempts, ten patients (23%) could not be reached by phone. However, no problems were identified at their follow up appointment. Conclusion: Using telephone contact before and after liver bx to assess patient status found minimal problems associated with percutaneous liver biopsy. We conclude that performing a liver bx in this population of patients poses a low risk of complications and can be considered a safe procedure.