Liver biopsy

In some situations, laboratory measurements do not provide enough information about the etiology of a specific liver disease. When there is an unexplained and persistent elevation of LFTs, a liver biopsy may be needed to establish the diagnosis and to provide prognostic information. An accurate estimate of the amount of liver fibrosis, inflammation or necrosis can only be made by liver biopsy.

In HCV infection, there is a poor correlation between symptoms or levels of alanine aminotransferase and histologic features of the liver. Thus, patients with HCV infection may have normal levels of liver enzymes and have significant fibrosis on biopsy. Conversely, patients may also have elevated serum ALT and trivial liver disease.

Indications for liver biopsy include:

Contraindications to Percutaneous Liver Biopsy
Absolute Contraindications
  • Uncooperative patient - requires positioning and breath holding
  • Bleeding
    • Prothrombin time 3-5 sec more than control
    • Platelet count <50,000/mm3
    • Prolonged bleeding time (10 minutes)
    • Use of NSAID within previous 7-10 days
    • Blood for Transfusion unavailable
  • Infection of the hepatic bed
  • Extrahepatic biliary obstruction
  • Inability to identify an appropriate site for biopsy by percussion or ultrasonography
Relative Contraindications
  • Ascites
  • Morbid obesity
  • Possible vascular lesions
  • Amyloidosis
  • Hydatid disease

Complications of Percutaneous Liver Biopsy:

Percutaneous biopsy procedure:



Please visit this Web Path site to inspect a normal liver biopsy specimen