1/10. A vanishing liver abscess complicated with klebsiella pneumoniae chest wall abscess: a case report.Septic metastasis is a unique feature of klebsiella pneumoniae liver abscess in taiwan. The case we report is a vanishing K. pneumoniae liver abscess with septic metastasis of the chest wall. The initial finding of a 36 year-old male with no previous medical history, was a huge hepatic mass presented on the sonography during a physical checkup. hepatitis b, C serology, tumor markers and evidence of metastatic diseases were all negative. A computerized tomography examination was also inconclusive about its nature. Due to the patient's refusal of a liver biopsy, only oral antibiotics were medicated at the outpatient department. Unexpectedly, the follow-up computerized tomography, taken 4 weeks later, demonstrated that the liver mass was nearly absent, while a protruding painful lesion developed over the right chest wall. Under sono-guided aspiration, the chest wall mass was proved to be a pyogenic abscess. The Gram stain revealed gram-negative bacilli and the bacterial culture yielded K. pneumoniae. Under the impression of K. pneumoniae liver abscess with chest wall septic metastasis, after performing percutaneous drainage of the chest wall abscess, the patient was only given parenteral antibiotics for treatment. Both the liver and the chest wall abscesses were at last completely eradicated.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/10. Hepatic abscesses in elderly patients mimicking metastatic disease.BACKGROUND: There is considerable overlap between the clinical presentation and radiological appearances of hepatic abscesses and hepatic metastases. The distinction is important given the treatable nature of hepatic abscesses compared with most forms of metastatic disease and the very high morbidity and mortality associated with untreated or missed pyogenic abscesses. AIMS: The aim of this series of case reports is to illustrate this point by presenting the case histories of three elderly patients whose clinical and radiological findings suggested metastatic liver disease, but who were subsequently proven to have liver abscesses. methods: A comprehensive review of the clinical and radiological records of three patients. RESULTS: Ultrasound and computer tomography (CT) imaging in all three cases was suggestive of metastatic liver disease. The liver lesions were subsequently proven to be abscesses either by autopsy, needle aspiration or inspection at open surgery. CONCLUSIONS: Liver abscesses can mimic metastatic deposits. Correlation with the white cell count (WCC) can be very helpful. Fine needle aspiration (FNA) of liver lesions should be undertaken, especially if the WCC is elevated.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/10. Early-onset liver abscess after blunt liver trauma: report of a case.A 23-year-old male patient underwent nonoperative management for his blunt liver trauma as he was hemodynamically stable without any signs of peritonitis initially after injury. A fever of 39.5 degrees C and severe right upper quadrant abdominal pain developed on the second day, and an abdominal computed tomography (CT) scan showed the formation of a gas-containing liver abscess in the traumatized liver. An emergency laparotomy revealed a foul-smelling liver abscess at the traumatized site, which was finally disclosed to be the result of a clostridium species infection. A liver abscess is a rare complication following the nonoperative management of liver injury, and such an occurrence is even more rare within 1 day after injury. A clostridium species infection is responsible for the fulminant progressing nature of the disease because the devitalized, ischemic liver parenchyma is ideal for such growth, and this is the first time that a such condition has been shown by CT images. Close observation with a high degree of suspicion is required for the successful treatment of such abscesses.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/10. Hepatic abscess. diagnosis in the adult by total body opacification.Two adults had the hypovascular nature of their hepatic abscesses ascertained by total body opacification. In one, total body opacification identified the hypovascular nature of the lesion, facilitating its differentiation from vascular hepatoma. In the other, the clinical diagnosis was acute cholecystitis with empyema of the gallbladder, and the liver was normal to inspection and palpation at celiotomy. Total body opacification may be helpful in the examination of abdominal masses.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
5/10. Metastatic septic endophthalmitis in pyogenic liver abscess.In a consecutive series of 180 patients with pyogenic liver abscess, three patients (two men and one woman, between 46 and 75 years of age) had metastatic Klebsiella endophthalmitis. The incidence of metastatic endophthalmitis was 1.7% in patients with pyogenic liver abscess, 5.2% in patients with Klebsiella liver abscess, and 7.8% in patients with Klebsiella liver abscess having Klebsiella bacteremia. Despite aggressive therapeutic measures, the men permanently lost their vision and the woman eventually required an evisceration of her right eye. Delayed recognition and/or treatment as well as the nature of bacteria probably contributed to the tragic outcome. The findings suggest that a high index of suspicion is critical and a combined effort of the internist and ophthalmologist is mandatory.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/10. Successful management of hepatic abscesses by percutaneous catheter drainage in chronic granulomatous disease.Chronic granulomatous disease (CGD) is a disorder of polymorphonuclear leukocytes that can cause multiple recurrent hepatic abscesses in 40% of those patients with the disorder. The mortality rate from this complication of CGD is estimated at 27%. Treatment has consisted of extensive surgical debridement and drainage and prolonged antibiotic therapy; however, this approach is accompanied by high morbidity and the frequent need for reoperation. Successful percutaneous drainage of multiple hepatic abscesses in a patient who had previously undergone 10 operative procedures to manage hepatic abscesses is reported. With the development of imaging and percutaneous drainage techniques, as well as the recurrent nature of this problem, percutaneous management should be given consideration in appropriate patients with CGD with hepatic abscesses.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/10. The relationship of computed tomography, gray-scale ultrasonography and radionuclide imaging in the evaluation of hepatic masses.Hepatic scintigraphy, gray-scale ultrasonography, and computed tomography have proven to be useful in the initial detection and evaluation of hepatic masses. These studies appear to be complimentary since each provides information not available from the others. Hepatic scintigraphy is currently the method of choice for the initial evaluation of the liver for mass lesions as it is easily performed, relatively inexpensive, and affords detectability of intrahepatic mass lesions at least as great as that of ultrasonography or computed tomography. When a definite or suspected abnormality is seen by hepatic scintigraphy, computed tomography or ultrasonography may be helpful in providing better anatomic definition or clarification of the nature of the abnormality. The choice between these latter two modalities depends on the type of scanning equipment available and the observer's experience with each method.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/10. Benign liver nodules presenting as apparent hepatic metastases: a report of 5 cases.Five cases are described in which hepatic nodules discovered as an incidental finding at laparotomy performed for other reasons were thought to be metastatic tumour. In each case histology and clinical course proved this assumption to be incorrect. It is emphasized that biopsy is mandatory in such circumstances to establish the diagnosis. Where the nature of the hepatic lesion might affect the choice of operative procedure frozen section examination should be performed at the time of surgery. Bacteriological culture may also be helpful.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/10. Multiorgan involvement in systemic cat-scratch disease.cat-scratch disease is considered in the differential diagnosis of benign regional lymphadenopathy. We describe a case of cat-scratch disease in a 12-year-old boy with multiple bony, hepatic and splenic lesions which resolved with chemotherapy. The present case with simultaneous multiorgan involvement supports the view of a systemic nature of the disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/10. Occult liver abscess following clinically unsuspected ingestion of foreign bodies.Two uncommon cases of foreign body (a wooden clothespin and a toothpick) perforation of the gur with associated pyogenic liver abscesses are presented. These cases illustrate the difficulties of preoperative diagnosis. The lack of history of ingestion of foreign bodies, variable clinical presentation of the conditions and radiolucent natures of the foreign bodies all play a role in impeding the diagnosis preoperatively. This report emphasizes the role of ultrasound and computed tomographic scan in evaluating similar cases. Any patient with known risk factors for ingestion of foreign body should arouse suspicion and be investigated further.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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