Sari Lutfullah, Rigiroli Francesca, Akyol Sari Zeynep Nur, Siewert Bettina, Brook Olga Rachel
Departments of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Eur Radiol. 2025 May 20. doi: 10.1007/s00330-025-11686-y.
Assess the incidence and clinical outcomes of inadvertent bowel sampling with a 17-G coaxial system with an 18-G semi-automatic biopsy needle, omental and mesenteric CT and US-guided biopsy.
In this retrospective study, consecutive patients undergoing omental and mesenteric CT and US-guided biopsy with a 17-G introducer, an 18-G semi-automatic biopsy device performed at a single tertiary academic institution between March 1, 2005, and March 1, 2024, were included to assess the incidence and clinical outcomes of inadvertent bowel sampling. Descriptive statistics were used.
Among 265 biopsies, there were six cases (6/265, 2.3%) with inadvertent bowel sampling identified on pathology. The median age was 83.5 years (IQR: 65.6-85.3) in patients with inadvertent bowel sampling, and 66 years (IQR: 58-74) in patients without inadvertent bowel sampling, p = 0.02. In patients with inadvertent bowel sampling, 4/6 (66.7%) of biopsies were from mesentery, in contrast to the patients without inadvertent bowel sampling, with 210/259 (81.1%) omental biopsies, p: 0.04. The bowel mucosa on pathology was arising from the colon in 3/6 (50%), the duodenum in 2/6 (34%), and the distal ileum in 1/6 (17%). All patients underwent a standard post-procedure observation time of 1 hour, during which no signs or symptoms of clinically significant bowel perforations were identified. No patients were admitted after the procedure, and no patients required admission within 30 days after the procedure for bowel-related indications.
Inadvertent bowel sampling during percutaneous omental and mesenteric biopsy with a 17 G introducer, and an 18 G semi-automatic needle is a rare, but likely benign event, even in patients without bowel preparation or antibiotic coverage.
Question The incidence and clinical consequences of unintended intestinal sampling in percutaneous omental and mesenteric core needle biopsies are unknown. Findings Inadvertent bowel sampling occurred in 2.3% of omental and mesenteric biopsies. No clinically significant complication was observed, despite the lack of bowel preparation or antibiotic prophylaxis. Clinical relevance Inadvertent bowel sampling is rare, more common in elderly patients and mesenteric biopsies, and likely benign, even without preparatory measures. However, given the potential for serious complications reported in the literature, meticulous technique remains crucial to minimizing the risk.
评估使用17G同轴系统和18G半自动活检针进行不经意肠组织采样、网膜和肠系膜CT及超声引导下活检的发生率和临床结果。
在这项回顾性研究中，纳入了2005年3月1日至2024年3月1日期间在单一三级学术机构接受使用17G引导器、18G半自动活检装置进行网膜和肠系膜CT及超声引导下活检的连续患者，以评估不经意肠组织采样的发生率和临床结果。采用描述性统计方法。
在265例活检中，病理检查发现6例（6/265，2.3%）存在不经意肠组织采样。不经意肠组织采样患者的中位年龄为83.5岁（四分位间距：65.6 - 85.3），无不经意肠组织采样患者的中位年龄为66岁（四分位间距：58 - 74），p = 0.02。在不经意肠组织采样的患者中，4/6（66.7%）的活检来自肠系膜，相比之下，无不经意肠组织采样的患者中，210/259（81.1%）为网膜活检，p：0.04。病理检查显示肠黏膜来自结肠的占3/6（50%），十二指肠的占2/6（34%），回肠末端的占1/6（17%）。所有患者术后均接受了1小时的标准观察时间，在此期间未发现具有临床意义的肠穿孔迹象或症状。术后无患者住院，术后30天内也无患者因肠道相关指征需要住院。
使用17G引导器和18G半自动针进行经皮网膜和肠系膜活检时，不经意肠组织采样是一种罕见但可能为良性的事件，即使在未进行肠道准备或未使用抗生素预防的患者中也是如此。
问题经皮网膜和肠系膜芯针活检中意外肠组织采样的发生率和临床后果尚不清楚。发现不经意肠组织采样发生在2.3%的网膜和肠系膜活检中。尽管未进行肠道准备或抗生素预防，但未观察到具有临床意义的并发症。临床意义不经意肠组织采样很少见，在老年患者和肠系膜活检中更常见，且可能为良性，即使没有准备措施。然而，鉴于文献中报道的严重并发症的可能性，细致的操作技术对于将风险降至最低仍然至关重要。
