NORCET 3 - 2022 (Shif…: Complications of Liver biopsy in children are?

NORCET 3 - 2022 (Shift-1)

Child Health Nursing (Pediatrics)

Easy

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

A liver biopsy is an invasive procedure that carries risks to adjacent organs and structures.
Bleeding (intra-abdominal hemorrhage) is a primary risk due to the liver's rich blood supply.
Bile leakage, leading to biliary peritonitis, can occur if the biopsy needle punctures a bile duct.
Pneumothorax (collapsed lung) is a potential complication, particularly with an intercostal (transthoracic) approach where the needle can injure the lung pleura.
Since all listed conditions are well-documented complications, "All of the above" is the most complete and correct answer.

Option A: This option is incomplete. While bile leakage is a serious complication of a liver biopsy, it is not the only one. Bleeding and pneumothorax are also significant risks.
Option B: This option is incomplete. Bleeding is the most common serious complication, but other risks like bile leakage and pneumothorax also exist and must be considered.
Option C: This option is incomplete. Pneumothorax is a possible complication, especially with a transthoracic approach, but it is less common than bleeding and does not represent the full scope of risks.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of pediatric liver biopsy as background academic context rather than a clinical decision trigger.
Nurses are responsible for crucial post-procedure monitoring to detect complications early. This includes frequent checks of vital signs, assessing the puncture site, and observing for signs of internal bleeding (tachycardia, hypotension) or peritonitis (abdominal pain, rigidity).
A key nursing intervention is positioning the child on their right side for several hours post-biopsy. This uses the body's weight to apply pressure to the liver's capsule at the biopsy site, which helps to tamponade bleeding and bile leakage.
What if? If a child has a known coagulopathy (e.g., low platelet count or prolonged prothrombin time), the risk of bleeding is significantly increased. The procedure might be contraindicated, postponed until the coagulopathy is corrected with treatments like platelet transfusions or Vitamin K, or performed via a lower-risk transjugular approach.

How to Approach the Question

First, read the question carefully to identify the core topic: 'Complications of Liver biopsy in children'. Note the plural 'complications'.
Next, evaluate each of the initial options (A, B, C) based on your knowledge of the procedure. Recall that a liver biopsy is invasive and involves a needle passing near several vital structures.
Consider each option: Is bleeding a risk? Yes, the liver is vascular. Is bile leakage a risk? Yes, the needle can hit a bile duct. Is pneumothorax a risk? Yes, if the needle passes through the chest wall.
Recognize that multiple options are individually correct. When this happens, look for a summary option like 'All of the above'.
Conclude that since Bile Leakage, Bleeding, and Pneumothorax are all established complications, the most accurate and comprehensive answer is 'All of the above'.

Concept Tested & Keywords

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 785-787