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

Hepatic actinomycosis is an uncommon entity that forms communicating abscesses and fistulae. We report a 53-y-old immunocompetent male patient with hepatic actinomycosis. Symptoms included intermittent fever, abdominal pain, right upper quadrant tenderness and jaundice. A hepatic tumour mass was found on abdominal sonography and computerized tomography. Two preoperative percutaneous core biopsies of the mass were not diagnostic. The above findings were highly suggestive for liver abscess or purulent primary liver neoplasm. Treatment with intravenous antibiotics was continued for 20 d, but both symptoms and liver ultrasound findings remained unchanged. The patient underwent exploratory laparotomy and right posterior segmentectomy of the liver. Pathological examination of the surgically removed specimen disclosed hepatic actinomycosis. Following operation the patient remains in excellent condition without evidence of recurrence.
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PMID:Liver resection in cases of isolated hepatic actinomycosis: case report and review of the literature. 1530 97

Liver abscess is a rare complication of liver biopsy but has not been reported in a patient with sickle cell disease (SCD) undergoing this procedure. The authors report the case of a child with SCD, on treatment with chronic transfusions and desferrioxamine, who developed a delayed liver abscess after a liver biopsy in which Avitene, a topical hemostatic agent, was used. This is the first description of a liver abscess as a possible complication of liver biopsy in a child with SCD. The presence of a hepatic abscess should be considered in the differential diagnosis of atypical abdominal pain in patients with SCD.
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PMID:Pyogenic hepatic abscess after percutaneous liver biopsy in a patient with sickle cell disease. 1570 87

A 63-year-old man presented to the emergency department with sudden-onset abdominal pain. Chest radiography demonstrated pneumoperitoneum. At surgery, the source was found to be a ruptured hepatic abscess. Cultures grew Clostridium perfringens, and biopsies confirmed metastasis of a previously resected pancreatic cancer. We document this rare cause of pneumoperitoneum and briefly review the literature on liver abscess as it relates to metastatic cancer.
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PMID:Liver metastasis presenting as pneumoperitoneum. 1575 62

Hemangioma is the most common primary tumor of the liver. The widespread use of ultrasonography (USG) and computed tomography (CT) has made the diagnosis more common. Although the vast majority of hemangiomas are diagnosed incidentally and are asymptomatic, treatment is still controversial. Surgery is the treatment of choice, especially in giant, symptomatic hemangiomas and uncertainty of diagnosis. Twenty-two patients (median age: 46 years) underwent resection (n = 12) or enucleation (n = 10) for liver hemangioma from 1989 to 2002. The primary indication for surgery was abdominal pain. Ten patients who were treated by enucleation were compared with twelve patients who were treated by liver resection. Mean tumor size was 90 mm with a range of 40-270 mm. There were no statistically significant differences in tumor size, preoperative liver function tests, hemoglobin levels, and platelet counts between the two groups. Operative time was longer in the resection group, and statistically significant the difference was (p = 0.048). Blood transfusion requirement and blood loss during intraoperative period were higher in the resection group (p = 0.025, p = 0.01, respectively). There were three postoperative complications, 1 in the enucleation group (pleural effusion), 2 in the resection group (liver abscess and wound infection). There was no surgery-related mortality in either group. Although most hemangiomas can be removed by enucleation or liver resection with low morbidity and mortality, if the location and number of hemangiomas are appropriate, enucleation is the choice of the therapy. Hospital stay, blood transfusion requirement, and blood loss can be kept minimal by the selection of enucleation.
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PMID:Giant liver hemangioma: therapy by enucleation or liver resection. 1595 41

Budd-Chiari syndrome is a rare condition resulting from outflow obstruction of the liver. This syndrome due to a pyogenic abscess is rarely documented in the English literature. Here a male patient with acute Budd Chiari syndrome is presented. A 21-year-old male patient was admitted to the hospital because of severe right upper quadrant pain, jaundice, hepatomegaly and fever. The examination of liver by computerized tomography and ultrasound revealed a large lesion 120 x l00 mm in size located in the right lobe of liver, which was compressing the inferior vena cava, the right and middle hepatic veins. Twenty-three days after percutaneous catheter drainage and medical treatment, the patient was discharged with complete healing. Although many disorders including malignant diseases can cause Budd-Chiari Syndrome, a pyogenic liver abscess compressing the inferior vena cava, and hepatic veins leading to acute Budd-Chiari syndrome has been rarely reported in English medical literature. Patients presenting with abdominal pain, hepatomegaly, and ascites should be carefully evaluated from this point of view.
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PMID:Acute Budd-Chiari syndrome resulting from a pyogenic liver abscess. 1620 Nov 17

We present an unusual case of empyema of the gallbladder associated with a pyogenic liver abscess in a patient with Crohn's disease on Infliximab. It manifested by weakness, weight loss, and vague abdominal pain, which eventually localized to the right upper quadrant 4 days prior to admission. Diagnostic evaluation, which included ultrasonography and computed tomography, revealed cholelithiasis, gallbladder wall thickening, and a low-attenuation, complex mass in the left hepatic lobe. Cholecystectomy and open drainage of the liver abscess were successfully performed. There are few reports of intrahepatic abscess associated with Crohn's disease. The relationship between acute cholecystitis and Crohn's disease has also been documented. However, this report documents the unusual complication of pyogenic liver abscess secondary to acute cholecystitis in the unique population of Crohn's disease patients on Infliximab.
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PMID:Staphylococcal liver abscess and acute cholecystitis in a patient with Crohn's disease receiving infliximab. 1636 99

Pyogenic liver abscess (PLA) is a potentially life-threatening disease, and early diagnosis may be difficult. In order to provide diagnostic clues and to enhance the prompt management of such cases, we retrospectively investigated the clinical characteristics of PLA during a 3-year period in a tertiary-care hospital. The crude incidence rate of PLA in our study was 446.1 per 100,000 hospital admissions. Male predominance and a mean age of 57.6 +/- 14.4 years were observed. Diabetes mellitus was the most common concomitant disease, and biliary pathologies were the most common predisposing cause of this type of abscess. The most common clinical features were fever, chills, and abdominal pain. Leukocytosis was found in 67.3% of the patients, and the observed C-reactive protein (CRP) values were high. The most common pathogen was Klebsiella pneumoniae. The mortality rate was 6.5%. A complete history, physical examination, evaluation of the white blood cell count and CRP, and the prompt arrangement of imaging studies may lead to an earlier diagnosis. The aggressive performance of image-guided catheter drainage and the appropriate administration of antibiotics may reduce the mortality rate of PLA.
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PMID:Pyogenic liver abscess: a retrospective analysis of 107 patients during a 3-year period. 1637 69

We report a case of liver abscesses associated with sigmoid colon cancer in an 81-year-old woman. The patient was referred to our hospital because of a tumorous lesion of the sigmoid colon. Five days before the scheduled operation, she presented abdominal pain, fever and chill. Imaging scans revealed multiple liver abscesses in both lobes, which were successfully treated with intravenously administered antibiotics. Two weeks later, the patient underwent laparoscopic-assisted sigmoidectomy. Nineteen cases of liver abscess associated with colonic cancer have been reported during the past ten years in Japan, and we report the clinical features of these cases in this paper. An aggressive search for the underlying cause of pyogenic liver abscess should be an integral part of the definitive treatment of this disease.
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PMID:Pyogenic liver abscesses secondary to carcinoma of the sigmoid colon: a case report and clinical features of 20 cases in Japan. 1645 62

Liver abscess can be caused by bacterial, parasitic, or fungal infection. Amebic abscesses are more common, but pyogenic abscesses account for three quarters of hepatic abscess in developed countries. Most common pathogens of the pyogenic liver abscess are Escherichia coli, Klebsiella pneumoniae, Bacteroides, Enterococci, Streptococci, and Staphylococci. However, liver abscess caused by Salmonella species has rarely been reported. We experienced a case of Salmonella liver abscess which improved after antibiotic therapy and percutaneous drainage. The patient was 52 years-old man who had an episode of intermittent fever, chills and epigastric pain for 2 weeks. He was diagnosed as liver cirrhosis eight years ago and diabetes three years ago. Salmonella group D, non-typhi was cultured from blood and pus from the liver respectively at the same time. With percutaneous drainage and susceptible antibiotic therapy, liver abscess decreased in size with improvements in fever and abdominal pain.
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PMID:[A case of Salmonella liver abscess]. 1663 85

A middle aged, non-addict male presented with right upper abdominal pain and swelling with respiratory distress. Examination revealed central cyanosis, bipedal pitting edema with prominent epigastric and back veins. Liver was enlarged, tender, spanned 20 cm without any splenomegaly or ascites. Other systems were clinically normal. Laboratory investigations showed polymorphonuclear leucocytosis with slightly deranged liver function. Abdominal ultrasonography showed an abscess in the right lobe of the liver with compressed inferior vena cava (IVC), middle and left hepatic veins. Arterial blood gas (ABG) documented hypoxia with orthodeoxia and air-contrast echocardiography was suggestive of an intrapulmonary shunt. A diagnosis of hepato-pulmonary syndrome (HPS) was made with near normal liver function secondary to amebic liver abscess. It reversed completely following successful treatment of the liver abscess.
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PMID:An unusual cause of dyspnoea complicating right upper abdominal swelling. 1681 Jul 74


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