CT-guided percutaneous lung biopsy in children: Complications and anesthetic management

Computed-tomography guided percutaneous lung biopsy (CT-PLB) is the technique of choice for the diagnosis of pulmonary lesions and mediastinal masses. It avoids the need for more invasive procedures such as thoracotomy or open lung biopsies. This procedure can be done under local anesthesia in adults, with or without sedation. However, in children, for better patient compliance general anesthesia with endotracheal intubation and controlled ventilation is preferred. Complications associated with this procedure are hemopneumothorax, hemoptysis, pulmonary contusion, and air embolism that could be life-threatening. Guidelines suitable for providing general anesthesia in patients posted for CT-PLB are lacking and anesthesiologists must adapt their practice to handle the challenges imposed and safely deal with any resulting complications. We report a case of CT-PLB in a 6-year-old child who developed complications of hemothorax, pulmonary hemorrhage, and aspiration of blood in the opposite lung.