The Additive Value of Chest Ultrasound Guidance to Abram's Needle Pleural Biopsy in Undiagnosed Pleural Effusion

Abstract

This study was conducted prospectively on fifty patients with undiagnosed exudative pleural effusion at Abbassia chest hospital during the period from March 2013 to September 2014. Two groups each 25 patients. Abram's needle pleural biopsy was performed in 25 of them with ultrasound guidance (Ultrasound guided Abram's pleural biopsy group –USAB) and in other 25 without ultrasound guidance (Abrams biopsy group –AB). This study included 15 males & 10 females in each group, with a mean±SD 52.36 -12.19 age year for USAB group and 46.68-14.17 for AB group. From the present study, the following results were obtained: The results of the present study showed that there were significant increase of the diagnostic yield of malignant pleural effusion in patients in USAB group (76%) when compared with AB group (28%). In the present study, there were no significant differences in the diagnostic yield of tuberculous pleural effusion in-patient in USAB group (16%) when compared with AB group (32%). In the present study, there was highly significant increase in pleural tissue obtained in USAB (100%) versus AB group (60%).

Complications developed in AB group were pneumothorax (4%), bleeding (4%), and pain (8%), while no complication recorded in USAB group. The different in the results between USAB group and AB group did not reach a significant value; this may be related to small number of patients study. In the present study, there was highly significant increase in the hospital stay among AB group (mean 28.20 days) versus USAB group (mean 11.16 days), this prolonged period of stay in AB group could be explained by the need to other procedures (e.g. medical thoracoscopy-open pleural biopsy) to reach the diagnosis.