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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An unusual case of liver abscess caused by fish bone perforation of the stomach is presented in this report. A 65-year-old woman was admitted to the Far Eastern Memorial Hospital for abdominal pain, fever and chills. Physical examination revealed anemia and tenderness in the epigastrium. Laboratory data showed leukocytosis and abnormal liver function. Computerized tomography of the abdomen disclosed a huge abscess in the left lobe of the liver. Exploratory laparotomy was performed and a fish bone, 3.7 cm in length, was found perforating the stomach with penetration into the left lobe of the liver, resulting in a hepatic abscess. Drainage of the liver abscess with removal of the fish bone and simple closure of the gastric perforation were performed. The patient recovered uneventfully.
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PMID:Liver abscess secondary to fish bone penetration of the gastric wall: a case report. 1006 13

Perforation of the gastrointestinal tract by ingested foreign bodies is rare. Preoperative diagnosis of complications due to foreign bodies in the gastrointestinal tract can rarely be achieved because the conventional radiographic appearance is nonspecific. This report describes a 69-year-old woman who presented with vague clinical manifestations, intermittent abdominal pain, and low-grade fever. Hepatic abscess, secondary to a foreign body penetrating the gastric wall, was diagnosed preoperatively using computed tomography findings. On exploration, the foreign body turned out to be a fish bone. The abscess was confirmed and drained during surgery and a partial gastrectomy was performed. This case illustrates the value of CT in the evaluation of this condition.
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PMID:Hepatic abscess due to gastric perforation by ingested fish bone demonstrated by computed tomography. 1008 73

Hepatic epithelioid hemangioendothelioma (HEH) is a very rare vascular tumor of the liver. It usually affects adult women and presents as multiple hepatic nodules with mainly peripheral distribution. It poses special difficulties for clinicians in its diagnosis and treatment because of its non-specific clinical manifestations and findings on imaging, and it is easy to be misdiagnosed pathologically. Its clinical course and prognosis are variable but supposed to be intermediate between hemangioma and angiosarcoma. The primary treatments of choice are radical resection or liver transplantation. We report a 62-year-old man with right upper quadrant abdominal pain of several days' duration, who was initially misdiagnosed as having a liver abscess. Finally, HEH was diagnosed on the basis of positive immunohistochemical staining for factor VIII-related antigen in tumor cells. This case could serve to highlight the pitfalls in diagnosing this rare tumor. Increasing the index of suspicion and familiarity with the radiological and histological characteristics of this tumor would facilitate the accurate diagnosis and thus avoid unnecessary interventions.
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PMID:Primary hepatic epithelioid hemangioendothelioma: case report. 1058 23

Cholangitis/cholangiopathy associated with the human immunodeficiency virus (HIV) infection is characterized by chronic abdominal pain, low-grade fever, cholestasis, and sometimes areas of focal or diffuse dilatation of the bile ducts that may be apparent on noninvasive imaging studies. Although the etiology of this biliary disease may be multifactorial, it appears to be the result of immunosuppression and/or secondary opportunistic infections rather than a direct cytopathic effect of HIV itself. Various opportunistic pathogens, including cytomegalovirus, Cryptosporidium, Campylobacter fetus, and Candida albicans, have been implicated as causes of HIV-associated cholangitis. We report an unusual case of polymicrobial cholangitis and liver abscess in a patient with HIV infection.
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PMID:Polymicrobial cholangitis and liver abscess in a patient with the acquired immunodeficiency syndrome. 1070 98

A 19-year-old woman with severe aplastic anemia who had previously failed antithymocyte globulin/cyclosporine A received high-dose cyclophosphamide without bone marrow rescue. On day +14, she complained of right upper quadrant abdominal pain and fever. A CT scan of the abdomen showed multiple liver abscesses with rupture and Klebsiella pneumoniae was isolated from blood. In spite of aggressive antibiotic therapy, she rapidly deteriorated and died of overwhelming sepsis. To our knowledge, our patient is the first case of fatal ruptured liver abscess after high-dose cyclophosphamide in a patient with severe aplastic anemia.
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PMID:Ruptured Klebsiella pneumoniae liver abscess after high-dose cyclophosphamide for severe aplastic anemia. 1086 21

In September 1993, we collected 207 patients due to dysentery, who visited the Department of Pediatrics at China Medical College Hospital. In our report, 67.6% of these patients were amebic dysentery, 19.3% were combined infection with amebic and Shigella sonnei dysentery, and 13.1% were Shigella sonnei dysentery. Therefore, amebic dysentery was the predominant cause during this outbreak. The clinical features of this outbreak were, in descending order, watery stool, fever, abdominal pain, mucinous stool and bloody stool. No concurrent liver abscess was discerned. Because there had not been such a clustering of dysentery in Taichung for so many years, we thought that travel to endemic areas might have been the underlying predisposing cause. Most of the school water supplying system was ground water, which might have been contaminated by a few patients returning from endemic areas. We thought that fecal-oral route by contaminated water might have been the primary transmission route.
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PMID:Clinical analysis of a dysentery outbreak in Taichung. 1091 May 50

There is a remarkable diversity of conditions encompassed by benign liver masses in infants and toddlers. The most common benign hepatic tumor in this age group is infantile hepatic hemangioendothelioma. Other commonly seen benign tumors are mesenchymal hamartoma and focal nodular hyperplasia. Hepatic adenoma is almost exclusively a disease of older children; primary hepatic teratoma is exceedingly rare. There are several distinguishing characteristics of these benign tumors on radiographic evaluation; however, imaging techniques such as ultrasound scan, computed tomography, and angiography are not always reliable in differentiating benign from malignant tumors. The differential diagnosis of benign hepatic tumors includes nonneoplastic cystic masses including biliary and simple hepatic cysts, hematoma, parasitic cysts, and pyogenic and amebic liver abscess. Choledochal cyst presents with a classic triad of abdominal pain, cholestatic jaundice, and a palpable abdominal mass. They are classified anatomically into 5 subtypes with the most popular types being type I and type IV. Treatment is with complete cyst excision with hepaticojejunostomy reconstruction.
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PMID:Benign liver and biliary tract masses in infants and toddlers. 1094 25

A hospital based retrospective study of amoebiasis was carried out for a ten-year period at the University Hospital, Kuala Lumpur. Of the 51 cases traced, 30 (59%) had amoebic dysentery, 20 (39%) were amoebic liver abscess (ALA) and one patient had both conditions. Entameoba histolytica trophozoites were identified in 13 (43%) of the amoebic dysenteric stools and 9 (30%) from biopsy. Of the 20 (39%) ALA cases, only one showed parasites in the stool and biopsy. Majority of the patients with dysentery were Malays while Chinese comprised 40% with ALA. Males predominated overall with a male female ratio of 3:1, while for ALA it was 9:1. Most of ALA were single (71.4%) and were localised in the right lobe. The majority of the patients were unemployed. Eighty three percent (83%) of the patients presented with diarrhoea or dysentery followed by abdominal pain while those with ALA had fever, chills, rigors and pain in the right hypochondrium. Eighty percent of the ALA cases showed hepatomegaly. All patients responded to treatment with metronidazole.
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PMID:Amoebiasis: a 10 year retrospective study at the University Hospital, Kuala Lumpur. 1104 54

Tuberculous liver abscess is rare worldwide. We report a 45-year-old man who presented with abdominal pain, fever and weight loss. Ultrasound and computed tomography of the abdomen showed multiple cystic lesions in the liver. Ultrasound guided needle aspiration revealed yellowish brownish aspirate, which was flooded with acid-fast bacilli. The abscess was drained under ultrasound guidance. Subsequent abdominal ultrasound a few days later showed resolution of the abscess cavity. He was concomitantly started on systemic antituberculous therapy. A tuberculous liver abscess has to be thought of in the differential diagnosis of liver abscesses and to consider the role of percutaneous drainage along with systemic antituberculous chemotherapy as an alternative to surgery in the management. A greater awareness of this clinical entity is required for successful treatment.
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PMID:Tuberculous liver abscess: a case report and review of literature. 1133 77

We described the clinical and bacteriological features of 12 cases of liver abscess caused by Streptococcus milleri group (SMG) during a 6-year period from 1993 to 1998. The gender was 11 males and 1 female with their ages ranging from 39 to 76 years old (mean: 53.4). The common symptoms were fever (100%), abdominal pain (67%), and appetite loss (58%). Nine cases had underlying diseases such as carcinomas and diabetes mellitus. Predominant causes of the liver abscess were cryptogenic (42%) and biliary tract disease (33%). Three patients died of an exacerbation of the carcinoma. Eight cases (67%) was single infection of SMG and no mixed infection with anaerobes. No strains isolated in this series showed resistance against penicillin G and ampicillin. SMG was highly isolated from the blood culture in eight of the 11 cases (73%). Liver abscess should be taken into consideration as one of the causes of SMG septicemia.
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PMID:[Clinical and bacteriological features of 12 cases of liver abscess caused by Streptococcus milleri group]. 1149 62


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