Introduction: Liver biopsies are the main method in the diagnosis and treatment of paediatric liver pathologies. Major complication rates of paediatric liver biopsies range from 0% to 6.6% in the literature and minor complication rates range from 0% to 25%. In this study, we aimed to review the complications, indications and results of percutaneous core liver biopsies with paediatric sonography in a tertiary care centre by an interventional radiologist. Methods: We retrospectively evaluated the results, indications and complications of paediatric liver biopsies performed in our tertiary health centre between January 2017 and December 2020. Biopsies were performed with a 16G semi-automatic needle in 17 patients (29.8%) and with an 18G semi-automatic needle in 40 patients (70.2%). Biopsies were performed only with local anaesthesia in patients older than 12 years; in younger patients, it was performed under general anaesthesia. Results: Fifty-eight liver biopsies were obtained from 57 children (34 males, 23 females). The most common indications were elevated liver enzymes (33 patients), cholestasis (14 patients), and adiposity and metabolic problems (6 patents). The most common pathological diagnoses were chronic hepatitis (33 patients) and steatosis (10 patients). Major complication in the form of symptomatic subcapsular haematoma developed after liver biopsy performed with 18G needle in only one patient (1.8%). Conclusions: As previously stated in the literature, percutaneous biopsies performed by interventional radiologists in paediatric patients under the guidance of sonography can be used in diagnosis and treatment; the complication rate is low and it is a safe method.
Spontaneous rupture of the common bile duct cyst is a rare cause of acute abdomen in children. In our case, we present a 3-year-old patient with no history of trauma, whose diagnosis was confirmed by laparotomy, with a possible suspected common bile duct cyst due to massive ascites and a cystic lesion in the portal area. Although common bile duct cysts are mostly asymptomatic, various studies have shown that malignant transformation can cause important complications such as pancreatitis.Numerous causes have been suggested in the etiopathogenesis of rupture, such as parietal necrosis associated with pancreatic reflux irritation.Since rupture of cysts may require urgent laparotomy such as biliary peritonitis, it is important to know imaging findings that may be warning for early diagnosis. Because of the increased risk of cholangiocarcinoma after cyst excision, cholecystectomy and Roux-en-Y hepaticojejunostomy are the most common treatment procedures.
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