CT Guided Lung Biopsy. A guide for patients undergoing biopsy

Transcription

1 CT Guided Lung Biopsy A guide for patients undergoing biopsy

2 Introduction The aim of this booklet is to: Answer your questions about CT guided lung biopsy Explain why you need the test Describe what is involved Inform you of the common risks and complications It is not meant to replace discussions between you and your doctor. It may be helpful for your partner, family or carer to read this as well. Why am I having a biopsy? Your doctor wants a sample from an abnormality in your lung. What is a CT? CT stands for Computed Tomography and is a form of x-ray scan. You may have already had a CT scan of your chest. Do I come into hospital before my biopsy? You will be told where to go on the day of your biopsy. Some hospitals may admit you to a ward and some hospitals may ask you to go to the x-ray department. Will I need tests before my biopsy? We will need blood samples to check your blood count and how well your blood clots. Your lung function will also be checked. We usually do these before your biopsy date but sometimes they are done on the day. What preparations do I need to make? You may eat and drink as normal on the morning of your biopsy. Take any medications as prescribed and bring your medications with you. Please bring an overnight bag in case you are admitted.

3 Important: Your doctor should have advised you to stop taking Warfarin at least 4 days before the biopsy. If not please contact your doctor via his secretary. Tell your doctor if you are taking other medications for thinning the blood such as aspirin, or clopidogrel (plavix). Some hospitals will ask you to stop taking these tablets for a few days before the biopsy and then restart them following your test. What will happen when I arrive at the hospital? A nurse will perform some simple checks. A cannula may be inserted into a vein in your arm. Blood samples may be taken What will happen in the x-ray department? A nurse may record your pulse and blood pressure. The doctor will explain the procedure, the risks and give you a chance to ask questions. You will then be asked to sign a consent form. We will do an initial scan and mark a spot on your skin to guide the biopsy. The skin is washed and local anaesthetic is injected into the skin which may sting as it starts to work. This numbs the skin but does not put you to sleep. If you have ever had a bad reaction to anaesthetic please tell the doctor. You might still feel some pushing and tenderness as we put the needle into the lung. If you feel pain, let the doctor know and more anaesthetic will be given. It is important to lie still and comply with any breathing instructions to avoid moving the needle which may cause complications. Several scans may be needed to help guide the needle and sometimes several attempts to adjust the needle may be required. T he doctor will usually take a few samples.

4 What happens after the biopsy? You will be taken back to the ward or observation area where nurses will monitor your breathing, pulse and blood pressure. You might have a chest x-ray taken. You may develop some pain at the biopsy site or in your shoulder but painkillers can be taken. CT SCANNER When can I go home? This is decided on an individual basis. In some hospitals you will be kept overnight but often patients who have someone at home and who are well following the biopsy will be allowed home that night. Can anything go wrong? Yes, although a lung biopsy is a relatively safe procedure there are some risks. Despite these risks, the biopsy is essential to obtain a tissue sample and to arrive at a diagnosis. In most cases it is without complications.

5 Risks of the procedure include: Pneumothorax (collapse of the lung) - a common complication that is usually small and doesn t need treatment. If it is large it may need to be treated by putting a drain (tube) into the chest. Less than one in thirty patients require a chest drain Bleeding into the lung - occurs in everyone to some degree. It is usually minor with less than one in twenty people having a large bleed. You may cough up a small amount of blood in the days following the biopsy. This may seem quite a lot as the blood is diluted with lung secretions. If bleeding persists, if there are large quantities (tablespoons ) or if you have pain or difficulty breathing you should attend A&E Very rarely (in up to one in seven hundred procedures) a patient may develop serious complications which may prove fata l Other possible problems: We may only get a small sample or one that is unhelpful in the diagnosis In difficult to reach abnormalities, only a few samples may be taken to reduce the risk of complications Even with a good sample the pathologist may not be able to work out the cause of the lung abnormality. In these cases the biopsy may need repeated or another test may be req uired How will I learn about my test results? Results will be sent to the doctor who asked for the biopsy. You should expect to hear soon and you may already have an appointment. Sometimes the doctor may contact you by phone.

6 Should I take any special precautions when I go home? Mild discomfort at the biopsy site should settle within 48 hours. Mild painkillers may be helpful. Avoid straining or lifting for 24 hours. Do not lift heavy objects for four days. If your usual activities involve lifting, ask you doctor what is safe to do. You should not fly for six weeks. If any of these problems arise: Shortness of breath, especially if it starts suddenly Coughing up large amounts of blood such as tablespoons (a small amount of blood can be normal in the few days following the biopsy) Fever Worsening pain or discomfort in your chest Please go to your local Accident & Emergency department. Contact details: Developed 2011, review 2013