PERCUTANEOUS PERICARDIAL BIOPSY - TECHNIQUE, EFFICACY, SAFETY, AND VALUE IN THE MANAGEMENT OF PERICARDIAL-EFFUSION IN CHILDREN AND ADOLESCENTS

This study describes our technique of nonsurgical percutaneous pericar dial biopsy (PPB), its efficacy and safety, and its diagnostic and the rapeutic usefulness in the management of pericardial effusion (PE) in children and adolescents. In an 8-year period, 19 selected patients, a ged 2 to 20 years, had PPB for evaluation and treatment of PE. Using t his procedure we procured multiple biopsy specimens from various areas of the thickened parietal pericardium, and also procured pericardial fluid for investigation. The biopsy material helped establish a specif ic etiologic diagnosis in 63% and helped exclude tuberculosis and mali gnancy in the rest (37%). The histopathologic diagnoses were tuberculo us pericarditis (37%), uremic pericarditis (16%), radiation pericardit is (5%), connective tissue disease (5%), and idiopathic pericarditis ( 37%). In tuberculous pericarditis, the biopsy specimen provided an imm ediate histopathologic diagnosis, and a higher culture positivity (71% ) than pericardial fluid (29%). In addition, the procedure was therape utically effective in relieving tamponade and in treating effusion. Ou r experience indicates that the PPB procedure has both diagnostic and therapeutic value, and it can be performed easily, safely, and without complications even in small children.