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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The hepatic manifestations were studied in 65 patients having uncomplicated primary attacks of vivax and falciparum malaria. Hepatomegaly due to a "non-specific reactive hepatitis" occurred in 57% of cases. Jaundice occurred in 15% of patients and was invariably associated with hepatomegaly. The clinical syndromes of jaundice and hepatomegaly in uncomplicated primary attacks of malaria have to be distinguished from those related to disorders like viral hepatitis, hepatic amoebiasis, typhoid hepatitis, infectious mononucleosis and Q fever. The causes for the jaundice and the pathogenesis for the hepatic lesions have been discussed.
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PMID:Jaundice and hepatomegaly in primary malaria. 79 14

The clinical findings in 56 patients with hepatic amebiasis are reviewed. This illness was most frequent in male black patients, 20-39 years old. The clinical picture is dominated by upper right quadrant abdominal pain, general malaise, pain on percussion of the right hypochondrium and tender hepatomegaly. Jaundice is not rare and appears to have no prognostic significance. The importance of early diagnosis is emphasized.
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PMID:Hepatic amebiasis, analysis of 56 cases. I. Clinical findings. 92 Jul 12

Studies were carried out from June 1974 to May 1975 on the socio-economic status, health and nutritional status of the people in 4 villages, in the irrigation area of the Nong Wai Pioneer Agricultural Project of Khon Kaen Province, Northeast Thailand. The result obtained were compared with those in 2 non-irrigated villages in the same province, in order to identify the health and nutritional problems which might arise during the water resource development in the irrigation area. It was found that in the irrigated villages 90% of the peoples were farmers, while in the non-irrigated villages all were farmers. The socio-economic status of the people in the irrigated villages was much better than those in the non-irrigated ones. The income per family in the former was about three times greater than that in the latter. In the study of the health conditions of the villagers, the vulnerable age group including pre-school children under 7 years of age and school children in the elementary school class 1 and class 2, aged 7-9 years old, served as subjects for investigation. Haematological and physical examinations revealed many children with mild to moderate anaemia, vitamin B2 deficiency and a few cases of hepatomegaly. Anaemic children were found to be more prevalent in the non-irrigated villages than in the irrigated area. The overall parasitic infection rates in children in the irrigated and non-irrigated villages were similar with respect to severity of the infection. Hookworm infection, opisthorchiasis, strongyloidiasis and giardiasis were the leading parasitic infections, while amoebiasis was rare. Ascariasis and trichuriasis were not found. However, the first two helminthic infections had a low grade of intensity. The nutritional status of pre-school children, showed that there were more children with good growth in the irrigated villages than in the non-irrigated one. Serum proteins, albumin and globulin, and urinary urea nitrogen-creatinine ratio revealed normal findings indicating that the children had sufficient protein intake. The results of the urinary hydroxyproline-creatinine index suggested that many of the children in both groups of the villages were at marginal malnutrition status. Surveys on domestic animals including cattle, buffaloes, pigs, and field rats revealed no important zoonotic diseases except leptospirosis in a few rats. Some fish were found to harbour metacercariae of Opisthorchis viverrini, while some snails were positive for cercariae of O. viverrini, Schistosoma spindale, and Echinostoma malayanum. The overall findings indicated that the water resource development by establishing better irrigation, resulted in an improved socio-economic and nutritional status among the villagers, but health conditions and associated parasitic diseases and some nutritional deficiency still existed in the children. However, the findings from this study provide only preliminary data concerning the socio-economic status, health, and nutritional status of the villagers in the irrigation area...
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PMID:Socio-economic, health and nutritional status of the villagers in the Nong Wai irrigation area, Khon Kaen, Northeast Thailand. 103 Aug 56

Bacterial hepatic abscesses are a rare but serious disease. They develop either secondary to injuries or ischemia of the liver, infections in the drainage area of the portal vein, systemic sepsis or biliary infections. An abscess secondary to injuries or ischemia of the liver or infections in the drainage area of the portal vein, is usually caused by a mixed flora consisting of gramnegative aerobes and anaerobic bacteria. Hepatic abscesses secondary to systemic sepsis contain Staphylococci or Streptococci, while in abscesses on the basis of biliary infections gramnegative organisms are found. Clinically, one can find signs of systemic sepsis, pain in the right upper quadrant and a tender enlarged liver. Jaundice is absent unless a biliary obstruction is present simultaneously. The diagnosis is confirmed by ultrasonography or computerized tomography. An uncertain diagnosis can be confirmed by aspiration under ultrasonographic or computertomographic guidance. The therapy consists of administration of antibiotics and surgical or percutaneous drainage. Surgical drainage via laparotomy is always mandatory if one suspects a primary infectious focus within the abdomen. The mortality of multiple liver abscesses is 20 per cent, that of single abscesses 10 per cent. Amebic abscesses have been observed in nonendemic regions sporadically after travel or spontaneously. Clinical and radiological manifestations are the same as for bacterial abscesses. They are differentiated from bacterial abscesses by positive serology for amebiasis or aspiration which yields the typical anchovy paste. Most important complications are hepato-bronchial fistulae, empyema and amebic pericarditis. The therapy consists of a nitroimidazole and a luminal amebicide. Except for diagnostic reasons aspiration is only indicated for large abscesses of the left lobe of the liver. Mortality of an uncomplicated amebic liver abscess should be under one per cent.
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PMID:[Pathology, diagnosis and therapy of liver abscess]. 330 50

The sera of patients with amoebic liver abscess, intestinal amoebiasis and non-specific hepatomegaly were examined for the presence of antibodies to Entamoeba histolytica antigen by enzyme linked immunosorbent assay (ELISA). All the amoebic liver abscess sera were strongly positive. The test was also positive in all the proved cases of intestinal amoebiasis but the ELISA values were relatively slightly lower. Nine of 10 cases of non-specific hepatomegaly with stools negative for E. histolytica gave positive results with ELISA. The IHA titre in all but one of the non-specific hepatomegaly cases was within normal value.
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PMID:Use of enzyme linked immunosorbent assay in intestinal and extra-intestinal amoebiasis (amoebic liver abscess). 627 81

The authors report upon 152 cases of hepatic amebiasis (H.A.) observed in France between 1969 and 1983, among young european men (average age 29,2) who were hospitalised in the initial phase of their illness. H.A. was clinically revealed through a painful and febrile hepatomegaly in 3/4 cases and in 6 cases through complications. No chronic form was observed. The amebic serology (I.F.I. and/or H.A.P.) was always positive. The research of an intestinal portage of the parasite was generally negative. The hepatic functions were impaired in the third of the cases. Whichever technique was employed, the anatomic diagnosis has always been made in a phase of intra hepatic collection. The superiority of echotomography over other methods is confirmed (especially for diagnosis of multiple abscess: 47% of success). All patients recovered, most frequently through medical treatment (117 cases). The nitro-imidazoles (1,5 to 2 g per day during 7 to 14 days) remain the prefered treatment, but they are responsible for 5 failures which were overcome by emetine. On the other hand, 4 patients had, after being cured, showed middle and long term relapses without patient recontamination. The evolution of the treated H.A. is significantly correlated to the importance and/or the multiplicity of the liver collection: the voluminous abscess of the right lobe being the most potentially dangerous. The pathogenesis of the H.A. remains imperfectly known. The different clinical aspects which have been found, depend upon the preexistant immunity of the patient and could also be equally associated with a pathology of complex immunity systems.
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PMID:[Hepatic amebiasis in France. Apropos of 152 case reports]. 639 77

The purpose of this study was to describe and analyse retrospectively the clinical, serological, anatomical and evolutive features of 152 cases of hepatic amebiasis in young adults, treated and followed up in France from 1969 to 1983. The disease was revealed 3 times out of 4 by tender hepatomegaly with fever, but only in 6 cases by complications. Serological tests (immunofluorescence or hemagglutination) were always positive for amebiasis, whereas Entamoeba histolytica was absent from stools in 96.7 p. 100 of the cases. Hepatic amebiasis always caused a hepatic abscess: in these cases, the superiority of ultrasonography over all other diagnostic methods was confirmed, especially concerning the detection of multiple abscesses (47 p. 100). Complete recovery was obtained by medical treatment in 117 cases, either alone (98 cases), or combined with needle aspiration (19 cases). Nitro-imidazoles are the simplest treatment, but nevertheless in 5 cases they were not effective. These patients were then treated with dehydroemetine, associated in 2 cases with surgery. Four patients relapsed at mid or long-term after apparent recovery, in the absence of any obvious reinfection. A significant correlation between the course of the treated disease and the size and number of abscesses was demonstrated: it was possible to define a group characterized by a slow and/or complicated course (with single abscess of the right lobe whose diameter is equal to or greater than 10 cm, or multiple abscesses). The pathogenesis of hepatic amebiasis is not yet fully understood.
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PMID:[Hepatic amebiasis: study of 152 cases]. 652 40

Amebic liver abscess was seen in 35 patients over a ten-year period at Cook County and the University of Illinois hospitals, Chicago; 32 had immigrated from an area of endemic amebiasis, but three were natives of Chicago. Typically they had right upper-quadrant abdominal pain and fever of short duration (nine days); on physical examination, upper abdominal tenderness and hepatomegaly were usually present. The diagnosis was confirmed by liver scan, serologic studies, aspiration of "anchovy paste" from the abscess, and/or a favorable response to specific antiamebic therapy. Most were solitary abscesses in the right lobe of the liver. Metronidazole treatment alone was adequate in 24 of 29 patients (83%). Nine patients underwent percutaneous or surgical drainage of the abscess owing to incorrect diagnosis (three), persistent pain and fever after medical treatment (three), expanding left lobe abscess (two), and for diagnosis (one). Mortality was 5.7% (two patients). Owing to current immigration patterns amebic liver abscess should be considered in the differential diagnosis of patients with right upper-quadrant pain and fever. The diagnosis should be confirmed with a liver scan and serologic study for amebiasis.
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PMID:Amebic liver abscess. 705 36

In 11 patients with childhood amebiasis, only two had dysentery. Additional clinical findings included hematochezia without diarrhea (four patients), dysentery with appendicitis (one patient), exacerbation of ulcerative colitis (two patients), and disseminated infantile amebiasis (two patients). All patients with hematochezia examined by proctosigmoidoscopy had colitis. The diagnosis of amebiasis was confirmed by microscopic examination of fresh stool specimens, pathologic findings, and/or serologic titers. Amebiasis should be considered in the differential diagnosis of infants and children with hematochezia or hepatomegaly, especially in endemic areas.
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PMID:Spectrum of amebiasis in children. 711 1

This retrospective study of hepatic amoebiasis cases observed in the clinic of Pediatrics from 1964 to 1979 brings evidence of its low frequency in children. The disease is mainly observed in young patients from 1 to 6 years (76,5%) and specially in males. Suspected from the evidence of a tender and enlarged liver associated with fever, the diagnosis is rapidly confirmed by a highly positive specific serology. Prognosis is severe with complications in 7% and death in 15% of the cases. Treatment is essentially medical and based on metronidazole. Surgical treatment has few indications which have been recently fixed by Nussaume and Cherbonnel.
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PMID:[Amoebic liver abscess in children (study of 47 cases observed from 1964 to 1979 in the clinic of pediatrics of Kinshasa University) (author's transl)]. 731 57


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