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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Amebiasis, that is, infection with Entameba histolytica, continues to be endemic in the United States, with liver abscess occurring as an infrequent but constant complication. Seven cases are reported, with epidemiologic investigation of two. Reliable findings in hepatic abscess include fever, abdominal pain, respiratory distress, tender abdomen, and large, tender liver. Anemia, elevated white count with left shift, and the radiographic findings of an elevated right hemidiaphragm are constant. Epidemiologically, amebiasis occurs in clusters in the United States with person-to-person transmission predominant in spread. Infection is associated with poor sanitation and crowding. Investigation of the families of two patients documented 9/21 carriers and an additional 3/21 who were seropositive, as well as crowding and poor sanitation. In this country, treatment of a patient with amebic disease should include investigation of his home and family.
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PMID:Amebic liver abscess in children: clinical and epidemiologic features. 51 19

A 10-year retrospective analysis of 15 patients with amebic liver abscess is reviewed and represents a continuation of the previous 2-decade experience at our institution (37 patients). Records were studied to determine the population affected, presenting symptoms, physical and laboratory findings, type and response to therapy. Most patients were rural males of lower socioeconomic status in the third to fifth decade of life. They presened as a febrile illness with abdominal pain for an average of 2 1/2 months duration. Significanct physical abnormalities were tender hepatomegaly (93%), right-sided pulmonary changes (40%), and fever (66%). All patients had abnormal liver scan, positive amebic serology, and hypoalbuminemia. All patients promptly responded to amebicidal therapy except one whose therapy was delayed. Clinical suspicion, liver scanning, serologic testing, and response to therapy are the keys to diagnosis.
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PMID:Amebic liver abscess: 1966-1976. 62 73

Five cases of childhood pyogenic hepatic abscess at Milwaukee Children's Hospital and 61 cases in the literature were reviewed. Hepatic abscess occurred most often in infants who had sepsis or umbilical infection. Cases in older children were associated with underlying host defense defects, particularly chronic granulomatous disease (CGD) and leukemia. Common clinical findings were fever, abdominal pain and hepatomegaly. Radionuclide scan was useful in diagnosis of lesions larger than 2 cm. Small or microscopic lesions were diagnosed at autopsy. Staphylococcus aureus was the most common etiologic agent. Mortality in all evaluable cases was 27% in patients with CGD and 42% in those without CGD. Open drainage and appropriate antibiotic therapy is the treatment of choice and should lower the mortality of this infection.
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PMID:Pyogenic hepatic abscess in infancy and childhood. 71 87

Solitary pyogenic hepatic abscesses were identified as the cause of fever, abdominal pain, and hepatomegaly in two otherwise normal children who were seen at St. Louis Children's Hospital during the past year. Liver function tests were normal and blood cultures were negative in both patients. These cases illustrate that pyogenic liver abscess may occur in normal children and should be considered whenever fever of unknown origin is associated with abdominal complaints. Only in this way can we hope to improve upon the results cited previously, namely that the majority of liver abscesses remain undiagnosed during life.
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PMID:Experience and reason--briefly recorded. 97 4

A 35-year-old male who had travelled extensively in the tropics presented with severe anorexia and vomiting associated with fever of 39-40 degrees C during a 4-day period. The clinical findings were entirely negative. In 1973, he had been given metronidazole for amebic dysentery, since when recurrent attacks of diarrhea and abdominal pain had been treated with iodoquinoleines. Stool examination was negative for amebae. Liver scan revealed a suspect "expansive process" in the right lobe. The presumptive diagnosis of amebic abscess was made and metronidazole therapy was started. In less than 24 h the patient became afebrile. The abscess was confirmed by a further liver scan. The definitive diagnosis of amebiasis was established 16 days later when the immunofluorescence level, which had been previously negative, became positive 1/480. This case demonstrates the dangers of the indiscriminate use of iodoquinoleines in patients who have travelled in tropical countries. The amebic liver abscess may be silent locally while causing systemic manifestations such as fever. Early treatment of hepatic amebiasis is recommended even with a presumptive diagnosis. Serological tests during the development of an amebic abscess may be negative and should be repeated after several days of therapy.
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PMID:[Amebic liver abscess of unusual presentation]. 99 99

Eighty-eight African patients with amoebic liver abscess are described. The diagnosis was readily made in pyrexial patients who had right-sided upper abdominal pain, an enlarged, very tender liver and signs at the right base. However, in apyrexial subjects (10%) and where abdominal pain was absent (7%), the diagnosis was considerably delayed. Five children (7%) were seen under the age of five, four of whom died because the diagnosis was not suspected. It is particularly emphasized that there should be a greater awareness of this condition in this age group. Amoebae were found in only a small percentage of stool (14%) and pus specimens (11%), while biopsy of the abscess edge yielded 40%. The relative values of a positive amoebic latex test (82%) and an elevated alkaline phosphatase (71%) are noted. In only half the aspirations was the classical anchovy sauce appearance seen. Metronidazole is the drug of choice with repeated aspirations for large abscesses. Mortality was 13-5%, occurring mainly in the extremes of life.
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PMID:Amoebic liver abscess in Rhodesian Africans. 100 58

The Authors review the medical records of 9 patients with liver abscess over a 15-year period from 1975 to 1989. They report on 5 pyogenic abscess, 3 amebic abscess and one case of tuberculosis of the liver. The most common initial diagnosis was fever of unknown origin, abdominal pain and hepatomegaly. The treatment consisted of 6 percutaneous transhepatic drainage, 2 open surgical drainage, and one explorative laparotomy (tbc infection). The Authors had no mortality and recommend the percutaneous transhepatic drainage as first-choice treatment.
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PMID:[Hepatic abscess]. 129 35

Two hundred cases of amebic liver abscess diagnosed between 1989 and 1991 at the Kasturba Medical College, Manipal were analyzed in this retrospective study. The clinical features and investigation reports were studied and the treatment and its response were analyzed. Amebic liver abscess constituted 0.6% of total hospital admissions during the study period. The male to female ratio was 13:1 with the most common age group of presentation between the fourth and fifth decades of life. Abdominal pain was the most common symptom (92%) and hepatomegaly was observed in 94% of the cases. Ultrasonogram of the abdomen served as the most useful diagnostic aid. Right lobe abscess was observed in 87% of the cases. Abscess was single in 81.5% of cases. Abscess size of more than 4 cm was observed in 46.5% of the cases. Metronidazole and chloroquine were found to be effective in most cases. Aspiration was done in 35.5% of cases. The complications encountered in this study were pleural effusion (two cases), pneumonic consolidation (four cases), pericardial effusion (one case) and ascitis (two cases).
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PMID:Profile of amebic liver abscess. 134 Mar 5

A 59-year-old woman who had undergone a Whipple's operation for carcinoma of the head of the pancreas, developed septic fever of up to 40 degrees C on the fourth postoperative day, accompanied by severe upper abdominal pain and local guarding on palpation over the liver. Her general condition markedly and quickly deteriorated. Liver abscess was suspected. Computed tomography demonstrated a hypodense, wedge-shaped lesion in the right lobe of the liver without any abscess capsule. Liver infarction was diagnosed when injection of contrast medium failed to show any increase in density. Magnetic resonance imaging confirmed the wedge-shaped signal-rich lesion. Laboratory tests revealed a leucocytosis of 30,000/microliters, a postoperative rise in serum alkaline phosphatase activity (up to 800 U/l), gamma-glutamyl transaminase (up to 190 U/l) and lactate dehydrogenase (up to 320 U/l), while GOT and GPT activities remained within normal limits throughout. Fever subsided within 3 weeks. --It is stressed that, if a patient's condition worsens after a major abdominal operation, liver infarction should be considered in the differential diagnosis. Modern imaging methods have increased the frequency of this diagnosis. They, together with the clinical picture and the pattern of biochemical tests, make it possible to distinguish reliably infarction from liver abscess.
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PMID:[Liver infarction after Whipple's surgery. Diagnosis based on clinical course and imaging procedures]. 134 77

Seventeen patients with hepatocellular carcinoma were treated by intraarterial injection of CTL suspension. The doses of CTL suspension, CDDP and THP(mean +/- SD)/injection were 4.1 +/- 1.6 ml, 81.9 +/- 31.6 mg and 13.5 +/- 5.2 mg, respectively. The therapy was given once in 10 patients, twice in 6 and 4 times in one. Over 50 per cent reduction in tumor size was obtained in 5 patients (30%). Fifty or more % decrease in serum alpha-feto-protein (AFP) levels was observed in 3 of 7 patients (43%) with the initial serum AFP level of more than 200 ng/ml, Fever, abdominal pain, nausea and vomiting were noted in most cases. However, they disappeared within 2 weeks after therapy was completed. No severe complications were encountered except one case of a liver abscess which healed by administration of antibiotics. No severe changes in laboratory data were observed. This study suggests that a new method of intraarterial injection must be developed to enhance the therapeutic effect even more, in addition to an increased injection dose of CDDP/THP-LPD and higher concentration of CDDP and THP in LPD.
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PMID:[Anticancer effect and side effect of arterial chemoembolization using cis-diamine-dichloroplatinum (II)/4-0-tetrahydropyranyl-adriamycin-lipiodol (CTL) suspension on hepatocellular carcinoma]. 138 72


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