Cases reported "Liver Abscess"

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1/48. liver abscess secondary to fish bone penetration of the gastric wall: a case report.

    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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2/48. Hepatic abscess due to gastric perforation by ingested fish bone demonstrated by computed tomography.

    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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3/48. Pyogenic liver abscess as a cause of acute upper abdominal pain. A report of two cases.

    The clinical course of 2 patients with acute abdominal pain, which was eventually found to be due to pyogenic hepatic abscesses is described. One patient, operated on late in the course, died; the other, who was operated on early, recovered. The importance of considering this life-threatening disease in the differential diagnosis of acute abdominal pain is emphasized.
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keywords = upper abdominal pain, abdominal pain
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4/48. 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.
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5/48. A man with fever, rigors, and poor oral hygiene.

    A 62-year-old man presented to the emergency department with a one-week history of subjective fever and rigors. He had had epigastric pain for three weeks, for which he was taking ranitidine, and in the past two to three months had experienced night sweats, a nonproductive cough, nausea, vomiting, and a 30-lb weight loss. He denied dsypnea, chest pain, hematochezia, melena, or any change in bowel habits.
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6/48. Polymicrobial cholangitis and liver abscess in a patient with the acquired immunodeficiency syndrome.

    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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7/48. chromobacterium violaceum infection in brazil. A case report.

    We report the second case of infection with chromobacterium violaceum that occurred in brazil. A farm worker living in the State of Sao Paulo presented fever and severe abdominal pain for four days. At hospitalization the patient was in a toxemic state and had a distended and painful abdomen. Chest X-ray and abdominal ultrasound revealed bilateral pneumonia and hypoechoic areas in the liver. The patient developed failure of multiple organs and died a few hours later. blood culture led to isolation of C. violaceum resistant to ampicillin and cephalosporins and sensitive to chloramphenicol, tetracyclin, aminoglicosydes, and ciprofloxacin. autopsy revealed pulmonary microabscesses and multiple abscesses in the liver. The major features of this case are generally observed in infections by C. violaceum: rapid clinical course, multiple visceral abscesses, and high mortality. Because of the antimicrobial resistance profile of this Gram-negative bacillus, for appropriate empirical antibiotic therapy it is important to consider chromobacteriosis in the differential diagnosis of severe community infections in brazil.
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8/48. Hepatic abscess as a complication of the sump syndrome.

    We report a case of hepatic abscess associated with the sump syndrome. The patient was a 66-year-old woman who had undergone cholecystectomy and side-to-side choledochoduodenostomy for a common bile duct (CBD) stone in 1983, and who presented with fever and right lower chest pain. A hepatic abscess was diagnosed; after it was drained, percutaneous transhepatic biliary drainage was performed. Bacteriological studies revealed the presence of bacteroides fragilis and streptococcus intermedius in the pus in the hepatic abscess cavity, and klebsiella pneumoniae and pseudomonas aeruginosa in the bile. The hepatic abscess and cholangitis rapidly resolved in response to two drainage procedures. At surgery, simple closure of the anastomosis was performed, because free drainage was observed from the distal CBD into the duodenum, despite the existence of a periampullary diverticulum.
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keywords = chest
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9/48. yersinia enterocolitica infection with multiple liver abscesses uncovering a primary hemochromatosis.

    A 60-year-old man, although treated with antibiotics, suffered from a severe pyrexial illness of unknown origin, weight loss and intermittent abdominal pain. There was no history of diarrhea or common infections. Computed tomography and ultrasound imaging showed uncharacteristic multiple small lesions of the entire liver parenchyma. These lesions were histologically pyogenic abscesses. In addition, an unexpected, pronounced accumulation of iron pigment in hepatocytes and second degree fibrotic changes of the liver were detected. serum iron and serum transferrin were low, but serum ferritin concentration and transferrin saturation were increased to the maximum. The demonstration of the cysteine-282-tyrosine mutation confirmed underlying primary hemochromatosis. Bacteriological cultures of the abscess material yielded yersinia enterocolitica serotype O:3, while stool and blood cultures were negative. Antibiotic therapy with piperacillin/tazobactam and tobramycin was successful within a few days. A repeat CT scan and ultrasound imaging demonstrated complete regression of the pathologic liver morphology. The patient was discharged and treated with an orally administered fluoroquinolone for an additional 6 months. After this time the patient had no morphological residues of the infection except one enlarged lymph node near the portal vein but still was so weak that he was unable to work again. In conclusion, severe septic forms of yersiniosis are mainly found in patients with iron overload, due to a handicapped iron metabolism of the Yersinia bacteria. mortality is high despite treatment.
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10/48. Behcet's disease complicated by pylephlebitis and hepatic abscesses.

    A 22 year old man presented with fever, abdominal pain, weight loss and diarrhea. Past medical history revealed recurrent aseptic meningitis, uveitis, and erythema nodosum. Further inquiry unveiled a prominent history of oral aphthous ulcers; all features of Behcet's disease. Imaging revealed mesenteric arteritis and pylephlebitis, septic thrombophlebitis of the portal vein, a previously unrecognized complication of Behcet's disease, with multiple intrahepatic abscesses. Portal venography demonstrated an extensively diseased, expanded, and obstructed portal venous system. blood cultures and portal vein aspirate yielded polymicrobial flora. Percutaneous intraportal thrombolytic therapy and mechanical thrombectomy were attempted to restore flow to the portal venous system. This distinctly rare manifestation of Behcet's disease, pylephlebitis, may result from ischemic injury and structural compromise of the bowel mucosa, resulting from underlying vasculitis.
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