ABSTRACT
Image guidance makes percutaneous biopsy and drainage safer and quicker, and blind needle biopsy is now appropriate only for the occasional superficial lesion. Fine-needle aspiration with immediate cytological examination may be appropriate for some indications. The most common indications for renal biopsy are nephrotic syndrome and impaired function following renal transplantation. Renal biopsy is performed under GA in young or uncooperative children, and with sedation or Entonox in older children. Renal transplant biopsy is performed in the supine position, and does not usually require GA or sedation because it is much less painful than biopsy of a native kidney. Open biopsy is performed when it is considered to be safer, or when other techniques have failed. Guidewire insertion and positioning of the drainage catheter can be monitored with US or fluoroscopy if necessary. Common causes of esophageal stenosis in children include congenital and surgical strictures, ingestion of corrosive substances, gastroesophageal reflux, achalasia, and dystrophic epidermolysis bullosa.
