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 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Complications of the initial 200 cases of laparoscopic cholecystectomy (LC) at the Cathay General Hospital within a period of 11 months were reviewed from video documents of the operations and clinical records. The major complication rate was 3.5%, including one common bile duct (CBD) injury (0.5%), three retained CBD stones (1.5%), one subphrenic fluid accumulation (0.5%), one liver abscess (0.5%) and one cystic duct stump bile leakage (0.5%). All major complications were cholecystectomy-related, and only one of the seven occurred in cases of acute cholecystitis. Age and sex were not related to its occurrence. The rate of minor complications ranged from 0.5% to 10%; they were: shoulder and back pain (10%), gall bladder perforation (10%), retained stones in the abdominal cavity (5%), transient nausea and diarrhea (5%), extension of umbilical port to a mini-laparotomy (3.5%), prolonged operation time > three hours (2%), subcutaneous emphysema (1.5%), wound infection (1.5%) and prolonged ileus (0.5%). The minor complications occurred largely in patients with acute cholecystitis. The complications occurred mostly during the early period of our study, indicating a learning period phenomenon. These could have been avoided if we had had a thorough knowledge of the potential complications and had strictly followed the principles of laparoscopic surgery. We conclude that LC is safe and the complication rate is not higher than that for open cholecystectomy. Most of the complications are preventable if LC is performed by qualified biliary surgeons following strict precautions.
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PMID:Complications of laparoscopic cholecystectomy: an analysis of 200 cases. 136 18

A 28-year-old man was admitted to the hospital because of fever, nocturnal dry cough and unspecific symptoms. Two years before admission he had worked as a sailor in South America, and one year ago he had been in Gran Canaria for a vacation. No serious illness occurred during these stays abroad. During the hospitalization the patient reported nausea and experienced upper right abdominal pain. Ultrasonography, computed tomography and serological tests revealed an amebic liver abscess. After administration of metronidazole the fever and symptoms subsided.
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PMID:[Fever and non-specific general symptoms]. 194 47

Twenty patients with primary hepatic carcinoma (PHC) treated by hepatic arterial embolization in our department from Dec. 1986 to Mar. 1987 are reported. There were 15 males and 5 females. The ages ranged from 34 to 75 years with an average of 50.7. Preoperative diagnosis and localization of the tumor were done by AFP, B-us, CT and angiography (right lobe 15 cases, left lobe 1 case, both lobes 4 cases). Celiac and superior mesenteric angiography was carried out by femoral artery approach and then highly selective hepatic catheterization was utilized for hepatic arterial embolization. Antitumor agent (5-Fu, adriamycin), iophendylate and foamy gel sponge were used for peripheral and proximal embolization. Manifestations were improved in most of the patients after embolization, such as relief of abdominal pain, improvement of appetite, decrease of tumor size. Total necrosis of the tumor was found in 2 patients who underwent surgery 1 month after embolization. The side effects of the posthepatic embolization such as, nausea, vomiting, abdominal pain and fever could be relieved by symptomatic treatment. No severe complications, such as gangrene of the gall bladder, hepatic failure, liver abscess, intestinal necrosis or pulmonary embolization were found except 3 patients who died of renal failure after the procedure. The liver dys-function returned to normal within 2 weeks. Hepatic arterial embolization provides an alternative treatment for the patients with PHC who has compensated liver function without severe systemic diseases, especially renal endocrine problems and severe portal hypertension. They should have patent portal system as proved by angiography. The authors considered that this therapeutic embolization with hepatic chemotherapy infusion is safe and effective in the management of PHC. It may increase the resectability and provide palliative means for the advanced and terminal cases.
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PMID:[Hepatic artery embolization for primary hepatic carcinoma]. 255 66

Intestinal parasites cause significant morbidity and mortality. Diseases caused by Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica occur in the United States. E. vermicularis, or pinworm, causes irritation and sleep disturbances. Diagnosis can be made using the "cellophane tape test." Treatment includes mebendazole and household sanitation. Giardia causes nausea, vomiting, malabsorption, diarrhea, and weight loss. Stool ova and parasite studies are diagnostic. Treatment includes metronidazole. Sewage treatment, proper handwashing, and consumption of bottled water can be preventive. A. duodenale and N. americanus are hookworms that cause blood loss, anemia, pica, and wasting. Finding eggs in the feces is diagnostic. Treatments include albendazole, mebendazole, pyrantel pamoate, iron supplementation, and blood transfusion. Preventive measures include wearing shoes and treating sewage. E. histolytica can cause intestinal ulcerations, bloody diarrhea, weight loss, fever, gastrointestinal obstruction, and peritonitis. Amebas can cause abscesses in the liver that may rupture into the pleural space, peritoneum, or pericardium. Stool and serologic assays, biopsy, barium studies, and liver imaging have diagnostic merit. Therapy includes luminal and tissue amebicides to attack both life-cycle stages. Metronidazole, chloroquine, and aspiration are treatments for liver abscess. Careful sanitation and use of peeled foods and bottled water are preventive.
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PMID:Common intestinal parasites. 1502 17

The aims of our randomized, single-blind trial involving 49 patients were to study the efficacy, side effects, and tolerance of metronidazole and satranidazole in patients of amebic liver abscess. Twenty-five patients received metronidazole (800 mg TID) and 24 received satranidazole (300 mg TID with placebo at mealtime). Patients recorded side effects and tolerability through a performa. The time taken for resolution of fever and pain and the fall in abscess size was not significant. However, tolerance of satranidazole as reported by the patients was significantly better than metronidazole (P < .005). The incidence of adverse effects was significantly lower in the group given satranidazole (P < .005). The incidence of nausea and metallic taste was significantly lower in the patients given satranidazole (P < .005). Thus, despite having a similar efficacy, satranidazole showed a far lower incidence of side effects and had a significantly better tolerance than Metronidazole.
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PMID:Randomized, single-blind, placebo-controlled multicenter trial to compare the efficacy and safety of metronidazole and satranidazole in patients with amebic liver abscess. 1710 40

There are few studies reporting pyogenic liver abscess (PLA) caused by Streptococcus constellatus in the medical literature. S. constellatus is a comensal microorganism that belongs to the Streptococcus milleri's bacteria group and is not considered to be pathogenic for humans. We report the case of a 23-year-old man with a 15-days history of abdominal pain in the right flank followed by daily fever, chills, nausea, vomits, sialism and jaundice. Physical examination revealed moderate jaundice (2+/4+), abdominal distention, generalized pain and tender over the right flank with positive Blumberg's sign. Additionally, the liver was palpable 5 cm below the costal margin in the right midclavicular line. Abdominal Computerized Tomography showed multiple hypodense hepatic images suggestive of liver abscesses. The patient underwent surgical exploration of the abdomen through a sub-costal incision and, during operation ruptured abscess localized on the hepatic segment III was drained. Culture of the purulent material obtained at surgery yielded Streptococcus constellatus as the causative agent. Liver abscess is a potential life-threatening disease that must be treated as soon as possible with invasive approaches, if necessary, and bacteriological studies performed when possible, allowing isolation of causative agents and specific antibiotic therapy.
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PMID:Multiple pyogenic liver abscesses caused by Streptococcus constellatus in the Amazon region. Case report. 1984 8

Pyogenic liver abscess in the pediatric population is a rare entity and can be difficult to manage. Surgical infections caused by Streptococcus anginosus are exceedingly rare. Here we present a case of pyogenic liver abscess caused by S anginosus in an adolescent presenting with fever, nausea, emesis, and right upper quadrant abdominal discomfort.
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PMID:Pyogenic liver abscess secondary to Streptococcus anginosus in an adolescent. 2043 8

A 45-year-old female was admitted to the hospital with a 1-week history of right upper abdominal pain and nausea. Ultrasonography showed a thickened duodenum with infiltration. Subsequent gastroscopy did not reveal any abnormalities. CT scan showed a foreign body perforation at the duodenum and a liver abscess (Fig. 1A,B). A diagnostic laparoscopy was performed. During the operation, the abscess was drained (Fig. 2A,B) and a sewing needle was removed (Fig. 3A,B). The patient claimed to have no recollection of swallowing the needle and made a quick recovery. Although rare, gastrointestinal perforations due to ingested foreign bodies most frequently occur at ileocecal, rectosigmoid, and duodenal regions[1]. Sewing needle perforations into the liver have been reported in children, adults, and psychiatric cases. Symptoms can vary from mild gastric pain to signs of peritonitis[2]. "Wait and see" is recommended for asymptomatic patients with no complications. Symptomatic patients (e.g., liver abscess) need surgical intervention[1,2,3].
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PMID:Liver abscess due to sewing needle perforation. 2069 49

Vibrio cholerae non-O1 have caused several well-studied food-borne outbreaks of gastroenteritis and also have been responsible for sporadic cases of otitis media, wound infection, and bacteremia. Few cases of liver abscess caused by Vibrio cholerae non-O1 have been reported. A 73-year-old man with underlying diabetes mellitus was admitted with nausea, vomiting, dyspepsia and febrile sensation. We identified Vibrio cholerae non-O1 in his blood cultures and multiple hepatic microabscess on abdominal computed tomography. He was treated with systemic antibiotics and fluid therapy, but died due to septic shock on sixth day. We report here, a case of liver abscess with bacteremia due to Vibrio cholerae non-O1 in a patient with diabetes mellitus.
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PMID:[A case of liver abscess and bacteremia caused by Vibrio cholerae non-O1]. 2219 34

Hepatic abscess is a rare complication of yttrium-90 radioembolization of hepatic tumors that most commonly occurs in patients with a history of biliary intervention. Patients usually present several weeks after therapy with pain, nausea, vomiting, and fever. Cross-sectional imaging is necessary in cases of suspected abscess to ensure prompt diagnosis and to help plan treatment, which involves antibiotics and percutaneous drainage.
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PMID:Hepatic radioembolization complicated by abscess. 2895 21


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