Korean Journal of Nephrology 1997;16(1):34-41.

색체 도플러 신초음파 검사를 통한 경피적 신침생검후 합병증의 추적평가

성이경 , 석준 , 박성배 , 김현철 , 손철호 , 우성구

Abstract

Between August 1995 and March 1996, we pro- spectively 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 ob- tained 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%), pseudoa- neurysm 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 hema- tomas thickness above 2cm were observed in 5 (5.6%) cases, 3 of these were severely symptomatic. Hematomas thickness below 2cm were asyrnptomatic and resolved spontaneously. Arteriovenous fistula occurred in 9(10%) cases, 7 of these resolved spon- taneously. However, in other two cases needed therapeutic arterial embolization. We conclude that follow-up post-biopsy evalua- tion with color-coded Doppler sonography is indica- ted only for symptomatic bleeding, large hematoma and the presence of AV fistula. Post-biopsy moni- toring with color-coded Doppler sonography will de- tect complications early and prevent serious compli- cations after percutaneous renal biopsy.