Percutaneous Biopsy of Abnormal Abdominal Lump (Ultrasound Guided)

Percutaneous Biopsy of Abnormal Abdominal Lump (Ultrasound Guided)

It has been recommended for you to have a biopsy of your lump using ultrasound (sound waves) guidance. A biopsy is when a small sample of tissue is taken from a part of the body. The sample will then be looked at under a microscope or may be tested in other ways. The examination will determine what problems (if any) there are with your lump and allow your doctor/consultant to advise you of the best treatment.

During the procedure you will be asked to lie on a couch. The ultrasound probe will then be gently passed over your skin to locate the exact position of your lump. The skin over your lump will then be cleaned with antiseptic solution. Some local anaesthetic will then be injected into a small area of skin and the surrounding tissues. The aim of this is to make the skin numb so that you do not feel any pain. Using the images which are shown on a television screen, a needle will be inserted through your skin, into your lump and samples will then be taken. You should not feel any pain, however, you may feel some pressure as the needle is inserted.

You will be asked to hold your breath for 5-10 seconds whilst the sample is being taken. This is because the lump moves slightly when you breathe in and out. As the needle comes out it brings with it a small sample of tissue.

This leaflet explains some of the benefits, risks and alternatives to the procedure. We want you to have an informed choice so you can make the right decision. Please ask your radiological team about anything you do not fully understand or want to be explained in more detail.

We recommend that you read this leaflet carefully.  You and your doctor (or other appropriate health professional) will also need to record that you agree to have the procedure by signing a consent form, which your health professional will give you.

Intended benefits of the procedure

The aim of the procedure is to find out if there is an abnormality with your lump and obtain a biopsy for a laboratory diagnosis.

Serious or frequent risks       

A biopsy is considered to be a safe procedure. Occasionally complications can arise because of the test’s invasive nature. These include:

1. Bleeding;
2. Internal bleeding from the biopsy site can occur. This bleeding will normally stop on its own. Occasionally the bleeding is more severe and a blood transfusion may be required.

• Infection;
• There is a small risk of infection at the biopsy site.

• Bile leakage;
• Internal leakage of bile from the biopsy site can occur. This leakage will normally stop on its own.

• Reaction to local anaesthetic;
• There is a small risk of a reaction to the drug used.

• Accidental biopsy of other organs;
• There is a small risk of injury to other organs including the lung, liver or bowel. This complication is substantially reduced by the use of the ultrasound guidance.

You will be cared for by a skilled team of doctors, nurses and other healthcare workers who are involved in this type of procedure regularly. If problems arise, they will be able to assess them and deal with them appropriately. As with all invasive procedures, there is a very small risk that you may die from complications of the procedure.

Other procedures that are available

There are no real alternative procedures which would obtain a sample from the right parts of the lump.

Your anaesthesia

A general anaesthetic is not usually required but as indicated above some local anaesthetic will be injected into your skin to help ensure that you are comfortable during the procedure.

Preparation for your procedure

You will need to have a blood coagulation test carried out before the biopsy. You will be informed of the arrangements for this test.

We will usually ask you to continue with your normal medication (except as instructed below) during your stay in hospital, so please bring it with you.

Please let the Imaging Department know if you have:

• had a heart valve replacement;
• suffered from endocarditis; or
• had a pulmonary shunt inserted.

Aspirin:

If you are taking aspirin regularly, please stop 5 days before the biopsy unless you have a high risk indication e.g. have had a cardiac stent inserted within the last twelve months.

Clopidogrel, Dipyridamole, Cilastozol and Prasugrel:

If you are taking any of these regularly please ring the Imaging Department. We will need to know why you are taking this medication and discuss this with you. You will need to stop taking these prior to your procedure, but this should only be done after discussion with the your doctor or referring Clinician.

Warfarin, Dabigatran and Rivaroxaban:

If you are taking any of the above, it may need to be stopped prior to the procedure and alternative medication should be arranged with your doctor or referring Clinician.  Please ring the Imaging Department on the number given on your appointment letter. We will need to know why you are taking this medication and what your target INR is.

If you don’t feel well and have a cough, a cold or any other illness when you are due to come into hospital for your investigation, we will need to know.  Depending on your illness and how urgent your investigation is, your procedure may need to be delayed.

On the day of the procedure

You will usually be admitted on the day of your procedure so we and you can prepare for the test. We will welcome you to the ward and check your details.  We will fasten an armband containing your hospital information to your wrist.

Prior to the examination the Consultant Radiologist who will be carrying out your examination will be available to answer any queries you may have. Please let us know in advance if you are allergic to any antibiotics or other drugs.

During the investigation

Before the procedure you will be asked to remove any glasses, dentures or jewellery that you may be wearing. In the examination room you will be made comfortable on an examination couch. The procedure will then be performed as described above.

After your investigation

We will usually take you back to the recovery area where you will be looked after by the nursing staff. If everything is satisfactory you will be allowed home. You will need to arrange for a relative or friend to collect you from the ward and drive you home.

Leaving hospital

Length of stay

Most patients having this type of test will be in hospital for less than 24 hours.

Medication when you leave hospital

Before you leave hospital, the pharmacy may give you any extra medication that you need to take when you are at home.

Convalescence

How long it takes for you to fully recover from your surgery varies from person to person. It can take one to 2 days.

Once home, it is important to rest quietly for the remainder of the day.

Please contact your GP if you have any of the following;

• excessive bleeding from the biopsy site;
• experience excessive sweating;
• experience excessive shivering; or
• generally feel unwell.

Wound

A small waterproof or gauze dressing will be placed over the site after the test and can be replaced if needed.

Personal hygiene

You will normally bathe or showeras normal after you leave hospital.

Diet

You don’t usually need to follow a special diet.  If you need to change what you eat, we will give you advice before you go home.

Exercise

You should not participate in strenuous sports for the first 10 days after your biopsy. You should avoid heavy lifting and carrying heavy shopping.

Driving

You should not drive until you feel confident that you could perform an emergency stop without discomfort.  It is your responsibility to check with your insurance company.

Work

When you return to work will depend on your job. If your job involves heavy manual work you may be advised to take a week off. If your job does not include manual work or lifting you may be able to return to work 2 days after the biopsy.

Test results

We will normally send the samples to a special laboratory in the hospital for tests. The results will not be available on the day of the examination. They will be sent to your referring consultant who will usually either write to you or arrange an outpatient appointment. 

Contact details

If you have any specific concerns that you feel have not been answered and need explaining please contact the following.

• Ultrasound Department, Worcestershire Royal Hospital (Phone 01905 760614)

Additional Information

The following Internet websites contain additional information that you may find useful:

Homepage – Worcestershire Acute Hospitals NHS Trust

Information about Worcestershire Acute Hospitals NHS Trust

Patient.info: Health Information and Symptom Checker
Information fact sheets on health and disease.

NHS website for England – NHS
On-line Health Encyclopaedia

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience

We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback

Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)

If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:

Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:

The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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