My husband had a liver biopsy 12 days ago. Everything was fine until last Sunday when he sneezed and felt pain at the needle site. His pain got gradually worse and it became hard for him to breath. On Wednesday he gave in and decided to go to the emergency room. They ran all these test from blood, X-ray, to a ct scan where he had to drink this special fluid that shows more on the scan. After all these tests the doctor tells him both of his lungs look partially collapsed and prescribes antibiotics and pain medication. The doctor says the pain might be from tearing scar tissue. My question is: how long should something like this hurt and when should I seek medical attention if the pain persists?
A number of complications have been reported after liver biopsy.
These include pneumothorax (collapsed lung), hemothorax ( a collection of blood in the space between the chest wall and the lung , perforation of any of several viscous organs, bile peritonitis, infection (bacteremia, abscess, sepsis), hemobilia, neuralgia, and rare complications such as ventricular arrhythmia with transvenous biopsy.
Pneumothorax (collapsed lung) is critical to recognize immediately after biopsy (reduced breath sounds, typical radiographic ﬁndings), because it can lead to immediate catastrophic outcomes if not promptly recognized and treated.
Collapsed Lung Causes
The primary cause of a pneumothorax is trauma to the chest cavity. A fractured rib, for example, could puncture the lung. In addition, penetrating trauma from a bullet, knife, or other sharp object can directly puncture the lung.
A collapsed lung refers to a condition in which the space between the wall of the chest cavity and the lung itself fills with air, causing all or a portion of the lung to collapse. Air usually enters this space, called the pleural space, through an injury to the chest wall or a hole in the lung. This result is called a pneumothorax.
In a simple pneumothorax, there is usually only partial collapse of a lung. The pressure built up in the lung cavity is not enough to cause cardiovascular dysfunction.
The collapsed lung may be severe enough to lead to decreased amounts of oxygen in the blood, causing the patient to feel short of breath.
This type of pneumothorax can be small and "stable", and not require emergency treatment. However, the pneumothorax may slowly or rapidly progress to cause more severe cardiovascular impairment and may often need to be monitored.
Collapsed Lung Medical Treatment
A simple pneumothorax often is treated in a similar fashion to the tension pneumothorax with a chest tube and admission to the hospital.
If the simple pneumothorax is small, and not expanding, the doctor may try various inhalation techniques with 100% oxygen to cause spontaneous re-expansion of the collapsed lung segment.
A small catheter can be placed in the chest and the air removed via suction techniques with a syringe and a 3-way stopcock.
After multiple collapsed lungs or persistent collapse, chemical or surgical adhesion of the lung to the chest wall (called pleurodesis) may be necessary and is performed by a pulmonary specialist.
Collapsed Lung Prognosis
The prognosis of pneumothorax depends on its cause.
For a spontaneous pneumothorax, there is an increased risk for another collapsed lung in the future.
If no tension is present, the condition is easily treated by removal of the air, which re-expands the lung and returns lung function to normal after a few days.
Tension pneumothorax is life-threatening and may be fatal.
* Some scarring to the pleura develops after treatment and can result in intermittent, sharp, localized, chest pain over the short term.
In general, once the pneumothorax has healed, there is no long-term effect on health. However, spontaneous pneumothorax can recur in up to 50% of people.
* When to Seek Medical Care
A doctor should be seen after any symptoms of chest pain are experienced, because of the possibility of other equally or more serious causes of chest pain.
After blunt trauma to the chest, such as a fall on the ribs, a doctor should be seen if you have any shortness of breath or pain associated with breathing.
If blood is coughed up (called hemoptysis) after chest trauma or rib injury, this can be a sign of a more serious condition and should be treated by a doctor.
Call 911 for emergency medical services if there is any significant chest pain or severe shortness of breath.
Penetrating trauma to the chest can fracture ribs or directly cause a collapsed lung. The penetrating trauma may be caused by any of the following:
- Stab wound from a sharp object
- Gunshot wound
- Blunt trauma that breaks a rib that punctures into the lung space.
- Any collapsed lung can rapidly deteriorate into the immediately life-threatening tension pneumothorax.
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