We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Below we will list the departments and units that form part of Vall d’Hebron Hospital and the main diseases that we treat. We will also make recommendations based on advice backed up by scientific evidence that has been shown to be effective in guaranteeing well-being and quality of life.
Vols saber com serà la teva estada a l’Hospital Universitari Vall d’Hebron? Aquí trobaràs tota la informació.
This is a puncture and aspiration of the bone marrow using a fine needle under local anaesthesia. Bone marrow material is aspirated through the needle (in the case of aspiration) or a small, cylindrical sample is obtained from the bone marrow inside the needle (in the case of biopsy).
This technique serves to study the bone marrow. It is essential for the diagnosis and monitoring of many blood diseases, as well as screening for other conditions. A bone marrow exam enables diagnosis of bone marrow or blood cell diseases such as leukaemia, lymphoma, myeloma, myelodysplastic syndrome, as well as non-haematological diseases that may affect the bone marrow, such as tumours from other origins, deposit diseases, etc. Following treatment of these diseases, bone marrow exams also help to evaluate treatment efficacy.
The area is sterilised with iodine and then local anaesthesia is applied. A fine needle puncture is then performed and the bone marrow (material from inside the bones) is aspirated. It is a simple technique that is usually practised on the hip bone (iliac crest) or the sternum. The aspirated material is subjected to different diagnostic procedures such as smears to assess cell morphology, microbiological cultures, immunophenotyping techniques, cytogenetic and molecular studies.
Aspiration and biopsy are simple techniques that are performed as out-patient procedures (they do not require admission to hospital) and under local anaesthesia and/or sedation. The total duration of the procedure is approximately 30 minutes, and at the end the patient can go home, needing only minor oral analgesia in case of local discomfort. A small bruise may occur at the puncture site, but this is not common.
A procedure that, by introducing a flexible tube (bronchoscope) into the nose or mouth, allows the bronchial tree to be viewed, for diagnostic and/or therapeutic purposes.
To examine the bronchial tree and obtain samples of secretions or tissues for analysis with the aim of gaining an aetiological diagnosis of the causative illness. It can also be a therapeutic test, allowing suction of secretions or clots, extraction of foreign bodies, permeability of the airway in lung tumours and treatment of complications resulting from lung transplant.
With the patient normally lying down and consciously sedated, the bronchoscope is introduced into the airway, administering local anaesthesia in the passageways (larynx, trachea and bronchi). After examining all the bronchi and identifying any possible lesions, samples are taken, which may include: bronchial aspiration, bronchoalveolar lavage, bronchial brushing, transbronchial puncture, bronchial biopsy or transbronchial biopsy.
Minor undesirable affects may appear, such as snoring, cough, fever, localised pain, nausea or sickness and coughing up small amounts of blood, which are usually self-limiting and present no risk to life. Less commonly, major complications may occur, such as haemorrhage, low blood pressure, high blood pressure, pneumothorax (entry of air into the thorax outside of the lung). In very rare cases, complications such as arrhythmia or arrest of the heart, respiratory depression or arrest and acute stroke, may be severe and require medical or surgical treatment, including a small risk of death.
Rigid bronchoscopy, CT-guided needle lung biopsy, mediastinoscopy, surgical lung biopsy.
The thyroid gland actively captures iodine for the synthesis of thyroid hormones. If radioactive iodine is administered, the weak radiation released can be detected and reveal information about the gland’s condition.
The test takes advantage of the affinity that the thyroid gland has for iodine. This affinity is increased in the case of hyperthyroidism, which is the situation in which scintigraphy is most useful.
To determine the shape, size and location of the thyroid gland. It can also detect nodules or areas of hyperactivity or hypoactivity.
A slightly radioactive isotope of iodine is injected intravenously. When it is captured by the thyroid gland, a gamma camera detects the gamma radiation from the iodine taken in by the thyroid gland and gives us an image of the gland and its more and less active areas.
Although a radioactive substance is used, the level of radiation is very low. It is not recommended in pregnant women.
An ultrasound can be useful in detecting nodules, but it does not given an idea of the level of activity in the same way as scintigraphy does.
Electroencephalography (EEG) records the electrical activity in the brain. During an EEG various electrodes are placed on the patient's skin to record brain activity.
An EEG can be performed under different conditions: With the patient asleep or even subjected to stimulus such as a flashing light, or after breathing deeply to introduce metabolic changes that reveal an area of the brain with unusual brain activity.
There are different types of EEG waveforms according to their frequency and bandwidth. In a healthy person, a normal EEG will produce alpha waveforms with a frequency of 8 to 12 Hz, and a voltage of 50 microvolts. In the same way, beta and delta waveforms may be detected corresponding to different pathologies. Neurological conditions that may benefit from an EEG are: epilepsy, brain tumours, brain abscesses, brain injuries, and cerebrovascular diseases such as heart attacks or haemorrhaging. EEGs can also be used during neurosurgery to detect and distinguish healthy and diseased brain tissue.
Sensors (electrodes) are placed on different parts of the head. This usually takes a few minutes and, as it is non-invasive, can be repeated as often as necessary.
An EEG is a routine test that poses no risks and can be repeated several times during a neurological illness.
Brain imaging tests are also useful and may allow more accurate diagnosis and treatment when combined with an EEG.
Kidney biopsy is an essential diagnostic procedure in the field of nephrology. Kidney disease has a noticeable effect on a patient's general health and can also be detected by the blood and urine tests taken. Imaging tests (renal ultrasound, CT scan and nuclear magnetic resonance imaging) provide information for diagnosing kidney disease, but the essential and indisputable test to be able to reach a diagnosis of kidney disease is a kidney biopsy.
This consists of extracting a very small sample of kidney tissue, just a millimetre or so in size, with a special needle. The needle is guided by ultrasound and under local anaesthetic with or without sedation, depending on the characteristics of the patient.
The sample obtained is processed by the Pathological Anatomy Department for observation using optical microscope, fluorescence microscope and electronic microscope techniques. This enables different parts of the kidney to be observed: the glomerulus, the tubule, and the blood vessels. Special liquids can also be used to reveal infections and toxicity produced by different medicines.
This is very useful both for diagnosing disease in the kidneys themselves, as well as a test to monitor a kidney transplant.
Although a kidney biopsy is not without complications worth mentioning, they occur rarely and can be resolved. Urine may contain blood, for example, although this generally stops by itself. Renal haematoma may also occur, which also does not require treatment. Accidental communication between an artery and a vein may also occur, which can be repaired via catheterization to close the anomalous communication.
Kidney biopsy is a common procedure in the Nephrology Department and complications occur in around 1-2% of cases, which are subsequently resolved. It is therefore considered a safe routine procedure.
Analytical testing provides a lot of information which enables the origin and severity of the kidney disease to be established. A kidney biopsy allows a microscopic study that is often essential. Genetic testing also provides very important information.
These tests serve to determine the origin of the kidney disease. There are many causes that may be genetic or acquired via a bacterial or viral infection, or resulting from a metabolic disease (diabetes) or an autoimmune disease such as lupus.
In addition to blood and urine tests, a kidney biopsy and/or a genetic analysis, imaging tests can also be useful.
A kidney biopsy may produce minimal bleeding that almost always stops by itself. If it doesn't, it can be controlled using an interventional radiology procedure, whereby the kidney is catheterised to close the area of bleeding. Genetic testing is increasingly used to decrease the need for a kidney biopsy. However, kidney biopsy continues to be the main diagnostic method for kidney disease.
Spinal taps are used to extract samples from the cerebrospinal fluid, which is a substance that surrounds the brain and spinal column and protects them from possible injuries. This contact means that when there is a process that affects these body parts, the liquid is altered and we can detect it by analysing it.
Using cerebrospinal fluid, we can measure pressure and take samples to perform different tests.
Thanks to these tests, several diseases can be diagnosed, such as neurological disorders and infections that affect the brain or bone marrow.
Spinal taps, or lumbar punctures, involve taking a sample of cerebrospinal fluid through the puncture with a needle in the lumbar area.
It is usually done with patients in the foetal position: lying on their sides with legs flexed so the knees touch the chest. Sometimes, the puncture is done with the person sitting and leaning forward.
Once the patient is in place, the area where the puncture is to be done is cleansed and disinfected. After administering anaesthesia, the puncture is performed between the two lumbar vertebrae with a spinal needle.
After this, we measure the pressure of the cerebrospinal fluid and take the sample, which will be from 1 to 10 ml.
The needle is then removed, the puncture zone cleaned and a bandage placed over the puncture area. Sometimes patients need to lie down for a while.
Spinal taps are the least aggressive way to get a sample of cerebrospinal fluid. Study of this liquid is essential to detect certain diseases that affect the brain and the spinal cord.
The stress test, also called ergometry, involves performing physical exercise with an exercise bike or a treadmill. Thanks to this technique, the specialist can diagnose or study an illness that has already been diagnosed that might not manifest itself when the patients are resting.
It is used to diagnose cardiovascular and respiratory diseases that usually do not manifest in resting conditions or to study the progress and condition of an illness that has already been diagnosed.
Before performing the stress test, two electrocardiograms must be taken, one with the patient lying down and the other with the patient standing up.
Afterwards, the test is performed during which the patient must exercise on a treadmill or exercise bike. As the test progresses, the difficulty increases gradually, in accordance with an established protocol. The duration of the test is 6 to 12 minutes, during which continuous electrocardiographic monitoring is taken and hypertension is measured several times.
During the test, the specialist should be especially careful at the point of maximum effort to detect angina and difficulties breathing or finishing the test.
Changes in the heart beat and blood pressure can sometimes appear
This test is performed to check if there are alterations in the motility (movements) of the stomach and the small intestine when fasting and after eating.
The gastrointestinal manometry allows us to detect changes in the movement of the oesophagus, as well as making sure the oesophageal sphincter opens and closes properly to allow food to pass properly from mouth to stomach. It is also useful for assessing the condition of the inner oesophageal sphincter and making sure it closes properly in people who suffer from acidity, heart burn, retrosternal pain or repetitive pneumonia. It also allows us to check the results of some treatments, surgical or otherwise, that affect stomach motility.
Firstly, a thin tube is inserted through the mouth that connects to a device that records the movements, a.k.a. motility, of the small intestine. We then check the device is placed properly using an x-ray.
During the test, patients should be lying down on a bed and given a light meal that they can easily swallow.
This test lasts an average of 6 hours.
Once the test is done, the professional interprets the results in order to define or discard a diagnosis.
The process of placing the probe is uncomfortable and can cause nausea, which disappears when the probe is in the right position.
It is a diagnostic test for patients with heart disease, or suspected heart disease, who have heart beat disorders, known as "arrhythmias." This technique allows us to know the type and severity of the arrhythmias, the place in the heart where they originate from and the disorders they produce, meaning we can better focus treatment.
To conduct an electrophysiological study, it is necessary for patients to have fasted, and they must be conscious, sedated and lying down. Once in the examination room, local anaesthesia is applied to the area of the skin where the puncture will be performed, which is usually the groin, the arm or the neck.
Through the veins or arteries where the puncture has been made, several catheters (very thin, long, flexible cables) that go to the heart, always under radioscopic control, are inserted. The catheters are used to constantly record the electrical activity of the heart from inside. They also serve as pacemakers, when they are connected to an external stimulating device. Sometimes it is necessary to administer a drug during the test to diagnose arrhythmia.
The duration of the study depends, and once the test is performed, the patient must rest in bed for a few hours.
It is common for patients to notice palpitations at many moments during the examination, as they may be caused by catheters or by the medication administered. Sometimes it may be necessary to apply an electric shock to solve a sudden problem. Most of the time the patient will only feel a slight discomfort in the puncture area, and bruising may occur, which will normally disappear on its own. Other complications related to the procedure (phlebitis, venous or arterial thrombosis, vascular complications requiring surgery, haemorrhages requiring transfusion, cardiac perforation with difficulty breathing, pulmonary or systemic embolism) are uncommon, although some of these are serious and require urgent action. The risk of death is highly unlikely (1 in 3,000).
Other risks or complications that could appear, given the clinical situation and personal circumstances.
Given your clinical condition, the benefits from performing this test far outweigh any possible risks. If complications appear, the medical and nursing staff on hand are qualified and able to try to solve them.
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