Ultrasound Guided Percutaneous Neck Biopsy

Ultrasound Guided Percutaneous Neck Biopsy

Imaging Department

Investigative procedure information leaflet

Ultrasound Guided Percutaneous Neck Biopsy

It has been recommended you have a biopsy using ultrasound guidance. A biopsy is when a small sample of tissue is taken from a part of the body, the sample will then be processed and examined under a microscope or may be tested in other ways. The examination will help determine what problems (if any) there are and allow your doctor or consultant to advise you of the best treatment. Percutaneous simply means through a small hole (often no more than a needle puncture) in the skin, rather than having to make a large incision.

Ultrasound scanning involves the use of high-frequency sound waves to produce pictures of the inside of the body; ultrasound exams do not use ionising radiation (X-rays). Ultrasound images are watched in real-time and show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels. Ultrasound imaging is a painless medical test that helps doctors diagnose and treat medical conditions.

You will be asked to lie on a couch and jelly placed on your skin. The radiologist will use a probe to examine the area of interest, determine precisely the area to take the biopsy and the best approach to make. Your skin will then be cleaned with antiseptic solution and local anaesthetic injected into a small area of skin and the surrounding tissues to minimise the discomfort associated with the procedure. You may be asked to hold your breath for 5-10 seconds whilst a needle is inserted, this should not be painful but you may feel some discomfort and pressure, one or more samples will be taken. Some techniques use a needle which produces a loud ‘click’ when the sample is obtained. You may feel some local discomfort following the procedure at the site of the biopsy.

This leaflet explains some of the benefits, risks and alternatives to, Ultrasound Guided Percutaneous Neck Biopsy to help you make the best, informed decision as to your treatment. Please ask the healthcare 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 the doctor (or other appropriate health professional) will also need to record that you agree to have the procedure undertaken by signing a consent form.

Intended benefits of the procedure

The aim of the examination is help determine what problems (if any) there are, by obtaining a sample of tissue for laboratory examination, and allow your doctor or consultant to advise you of the best treatment.

Serious or frequent risks       

Your doctor has decided to recommend you have this procedure undertaken to help in your continuing treatment, in so doing they have balanced the benefits against any potential risks associated with it.

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

• Bleeding;

Internal bleeding from the puncture 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.

• Reaction to local anaesthetic;

There is a small risk of a reaction to the drug used.

• Accidental injury to other structures;

There is a small risk of injury to other structures in the neck including blood vessels or nerves. This complication is substantially reduced by using ultrasound guidance.

• Ultrasound has no known side effects.

You will be cared for by a skilled team of doctors and healthcare professionals who are involved in this type of procedure regularly. If problems arise, we 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.

Please let the Imaging Department know if you have;

• had a heart valve replacement;
• suffered from endocarditis;
• had a pulmonary shunt inserted;
• are taking any of the drugs mentioned below; or
• any allergies.

Your anaesthesia

Local anaesthetic will be injected to help ensure that you are comfortable during the procedure.

Preparation for your procedure

You can usually continue with your normal medication, except those listed below in which case please inform your doctor and the radiology department.

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 or Prasugrel

If you are taking any of these regularly, please ring the Interventional Radiology Department on 01527 50 30 30 EXT 44603. 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 Referring Clinician.

Warfarin, Dabigatran, Rivaroxaban or any other blood thinning medication

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 referring Clinician.  Please ring the Imaging department on 01527 50 30 30 EXT 44603. We may need to know why you are taking this and what your target INR is.

On the day of the procedure

You should attend your appointment 15 minutes before the stated time.  Prior to the examination the Consultant Radiologist who will be carrying out your procedure will be available to answer any queries you may have.

During the investigation

In the examination room you will be made comfortable on the couch. The procedure will then be performed as described above.

After your investigation

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

Convalescence

How long it takes for you to fully recover from your biopsy 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.

If you have any of the following;

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

Please contact your contact your GP or NHS 111

Personal hygiene

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

Diet

You will be able to eat and drink as normal after the procedure.

Exercise

You should not participate in strenuous sports for the first 24-48 hours after your biopsy. You should also avoid heavy lifting and carrying heavy shopping on the day of your procedure.

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 the day off.

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.

• Interventional Booking Team
• Phone 01527 50 30 30 EXT 44603

Additional Information

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

• Symptom Checker, Health Information and Medicines Guide | Patient

Information fact sheets on health and disease

• www.worcsacute.nhs.uk

Worcestershire Acute Hospitals NHS Trust

• www.radiologyinfo.org

For information on a wide range of radiological procedures.

• www.nhs.uk

On-line Health Encyclopaedia and Best Treatments Website.

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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