Evaluation of Complications after Percutaneous Renal Biopsy with Color-Coded Doppler Sonography

Seong, Y K; Suk, J; Park, S B; Kim, H C; Sohn, C H; Woo, S K

Abstract

Between August 1995 and March 1996, we prospectively studied 90 consecutive ultrasound-guided percutaneous renal biopsies to evaluate the incience of complications and its evolution. All biopsied patients were monitored through a routine follow-up color-coded Doppler sonography at post-biopsy 1, 7, 14 and 30 days. Adequate tissue for histologic diagnosis was obtained in 93.3% of patients. The complications after percutaneous renal biopsy were perirenal hematoma in 46 cases(51%), arteriovenous(AV) fistula in 9 (10%), pain requiring narcotics in 6(6.7%), pseudoaneurysm in 5(6%), transient hydroureter in 3(3%) and gross hematuria in 2(2%). Perirenal hematoma was the most frequent complication in our series. Most of these were clinically silent. But large hematomas thickness above 2cm were observed in 5 (5.6%) cases, 3 of these were severely symptomatic. Hematomas thickness below 2cm were asymptomatic and resolved spontaneously. Arteriovenous fistula occured in 9(10%) cases, 7 of these resolved spontaneously. However, in other two cases needed therapeutic arterial embolization. We conclude that follow-up post-biopsy evaluation with color-coded Doppler sonography is indicated only for symptomatic bleeding, large hematoma and the presence of AV fistula. Post-biopsy monitoring with color-coded Doppler sonography will detect complications early and prevent serious complications after percutaneous renal biopsy.