SEARCH · Search PubMed
Results for “Liver Abscess”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Multiple pyogenic liver abscesses cured with massive doses of penicillin.
Explore the source record for details and available documents.
[Intraperitoneal rupture of a liver abscess].
Explore the source record for details and available documents.
Solitary pyogenic liver abscess; review of literature and report of case.
Explore the source record for details and available documents.
Cell-mediated immunity in amoebic liver abscess.
Cell-mediated immunity studies were carried out in 26 cases of amoebic liver abscess by the leucocyte migration inhibition test and in 23 cases by T-cell counting. The tests were repeated after treatment and clinical recovery in 20 and 18 cases respectively. In addition, the leucocyte migration inhibition test was performed on 20 normal healthy controls and 11 Entamoeba histolytica cyst passers, and T-cell counting was carried out on 18 normal healthy controls and nine E. histolytica passers. The results of the present study show a transient state of immunodepression which may help E. histolytica to evade the defence mechanism of the host, and thereby invade target cells and produce liver abscess. This immune response is reversed after treatment and clinical recovery.
[Pyogenic liver abscesses: analysis of 36 cases treated by percutaneous drainage].
Thirty-six patients with pyogenic liver abscess treated by percutaneous drainage plus antibiotic therapy were reviewed. The most frequent symptoms were fever (75%) and pain (72.2%), and the most common physical signs were liver enlargement (58.3%) and jaundice (33.3%). The mean time interval from admission to diagnosis was 16 days. CT scans and ultrasonography were diagnostic in 100% of the patients. The percutaneous drainage was effective in one attempt in 19 patients, two attempts in 8, three attempts in 8 patients and more than four attempts in only one patient. There were three patients with hemoperitoneum (8.7%) as a post-drainage complication, one of them needed to be treated surgically. Mean hospital stay was of 24.8 days and the mortality rate was 5.5%. Percutaneous drainage plus antibiotic therapy is then an efficient therapeutic approach to the treatment of pyogenic liver abscess.
Liver abscess in inflammatory bowel disease: report of two cases and review of the literature.
Hepatic abscesses are a rare complication of inflammatory bowel disease (IBD). Despite the fact that certain hepatobiliary complications of IBD, including cholelithiasis, primary sclerosing cholangitis (PSC) and cholangiocarcinoma predispose patients with IBD to ascending cholangitis, previously published data does not demonstrate that biliary infection is an important mechanism underlying liver abscess development in these patients. We describe two patients with inflammatory bowel disease, both with PSC, who developed multiple liver abscesses, and review the literature on liver abscesses in association with inflammatory bowel disease.
Clinical features and management of amebic liver abscess. Experience from 29 patients.
29 patients with amebic liver abscess were evaluated in a study to examine clinical picture, laboratory data, epidemiology, radiologic methods, and therapy. Since the clinical picture was unspecific a considerable amount of misdiagnoses occurred, and often originated from pulmonary symptoms. To establish diagnosis one should rely on the triad with positive amebic serology, intrahepatic scanning defects, and clinical picture with fever, right upper quadrant pain, and hepatomegaly. Nearly all patients had an exposure history of travel or immigration from endemic areas in the tropics. Medical therapy with metronidazole alone is highly effective and leads to defervescence and clinical improvement usually within 3-5 days. Invasive procedures, such as needle aspiration or surgical drainage of the abscess are rarely needed; these invasive methods neither shorten the course of the disease nor improve prognosis.
Nosocomial liver abscess caused by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae.
A nosocomial pyogenic liver abscess caused by an extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolate presented in a man with adenocarcinoma of the stomach. The K. pneumoniae strain isolated from blood and liver aspirate cultures after antibiotic therapy for recurrent bacteremia was resistant to all extended-spectrum beta-lactams except imipenem and differed from K. pneumoniae strains causing community-acquired liver abscesses.
Anaerobes in liver abscess.
Non-spore-forming anaerobic bacteria are recognized as the most numerous and important pathogens in pyogenic liver abscess. These infections are usually polymicrobial. Frequent causes of anaerobic liver abscess are acute and chronic inflammatory bowel disease with or without perforation, malignancy and/or surgery of the gastrointestinal tract or pelvic organs, and biliary tract disease. Many abscesses are still classified as cryptogenic. A thorough understanding of bacterial etiology and the use of refined and accurate localizing and diagnostic techniques facilitate early diagnosis and effective treatment. In addition, the availability of bactericidal antimicrobial agents with extended spectra of activity against anaerobes and their use in selected cases is changing the classic therapeutic approach of antimicrobial therapy and open surgical drainage. Percutaneous aspiration has been used successfully in lieu of open drainage in several cases and antimicrobial treatment without drainage has been successful in others.
[Pyogenic liver abscess. Experience with 50 cases].
During the last years the diagnosis and treatment of pyogenic liver abscess has changed substantially. The aim of this work is to report a retrospective analysis of 50 patients aged 24 to 87 years old, that presented with a pyogenic liver abscess and were treated in the last 13 years. The sensitivity for diagnosis of ultrasound examination, CAT scan and angiography was 68, 89 and 75% respectively. The origin of the abscess was detected at the biliary tree in 46% and remained unknown in 38%. Thirty one patients were operated, 13 were subjected to percutaneous drainage and 5 were treated only with antimicrobials. Forty percent of patients had a septic complication and 4 (8%) died. Mean hospital stay was 31 days for operated patients and 21 for the rest. The abscess recurred in seven patients and two of these had a gallbladder carcinoma. It is concluded that percutaneous drainage is an alternative to surgical treatment that must be accompanied by a careful diagnostic workup.
[Pyogenic liver abscesses: a study of 25 cases].
OBJECTIVE: Our aim was to study the anatomo-clinic particularities and the therapeutic modes of the infectious abscesses of the liver. PATIENTS AND METHODS: Our retrospective study concerns 25 cases of the infectious abscesses of the liver collected on one period of 12 years from January 1992 to December 2003. They are 11 primitive abscesses and 14 secondary abscesses. RESULTS: We noted 14 women and 11 men, median age was 51.5 years. The Fontan triad was present in 7 cases. A liver mass with an abdominal sensitivity was found in 14 cases. Anomalies in the biologic exam of the liver were present in the 1/3 of the cases. We noted a double right and left localization in 3 cases and a multiple localization in 1 case. The hemoculture and the pyoculture permitted a bacteriological diagnosis in 52%. The percutaneous treatment achieved in 7 cases, permitted the recovery in 2 cases. One dead was noted following a severe cardiopathy. A surgical drainage has been achieved at 22 patients. 4 cases after the failure of the percutaneous treatment. Mortality rate was 20% (5 cases) related to the delay of diagnosis, the gravity of the septic shock. the advanced age and the flaws associated. CONCLUSION: The infectious abscess of the liver was a serious affection that affects the vital prognosis. The percutaneous treatment associated to the antibiotherapy. is the method of choice in the treatment of the abscesses of the liver. The surgical treatment must be reserved to the failure of the percutaneous treatment.
CT of amebic liver abscess.
CT findings in 23 patients with amebic liver abscess were analyzed retrospectively. A solitary abscess was present in 17 patients. Five patients had two to five lesions. One patient, a male homosexual, had 15 abscesses. Of the 46 abscesses, 74% occurred in the right lobe. The lesions were generally round or oval. One-half of the abscesses were 2-6 cm in diameter; 11% measured 13-16 cm. An enhancing wall was present in most cases. An incomplete rim of edema was seen in eight abscesses. The margin of the abscess was smooth in 63% and nodular in 37%. Internal septations were noted in 30%. Four patients had focal intrahepatic biliary dilatation peripheral to an abscess. One patient had intraabscess hemorrhage. Extrahepatic abnormalities were present in 18 patients; right pleural effusion (nine), perihepatic fluid collection (five), gastric or colonic involvement (eight), and retroperitoneal extension (one). Gas within an abscess was due to hepatobronchial fistula in one patient and hepatocolic fistula in another. Amebic abscess should be included in the differential diagnosis when CT shows one or more cystic or complex masses in the liver, especially when there is evidence of extrahepatic extension.
Entamoeba histolytica: induction of cyclooxygenase-2 expression during amoebic liver abscess formation in hamsters (Mesocricetus auratus).
Experimental amoebic liver abscess in hamsters curses with an increase in both, systemic levels of prostaglandin E2 (PGE(2)) and local cyclooxygenase activity in liver microsomes. The cellular source of PGE(2) and the isoform of cyclooxygenase responsible are not completely evidenced. Cyclooxygenase-2 (COX-2) protein and gene expression were demonstrated on macrophages and polymorphonuclear cells as a result of Entamoeba histolytica infection in hamsters at 2, 4, and 7 days postinfection by immunohistochemistry and RT-PCR. E. histolytica trophozoites located in the lesion showed a strong positive signal for COX-2, however the enzyme was not detected in cultured trophozoites by Western blot. Our results indicate that the increment in PGE(2) is the result of COX-2 activity from cells of the reticuloendothelial system and reinforce the possibility that PGE(2) production by enzyme induction in macrophages may be a mechanism by which E. histolytica modulates the host immune response in this parasitic infection.
Amebic liver abscess rupturing into the lesser omentum space.
A case of an amebic abscess localized in the lesser omentum is reported. There was no sign of a liver abscess in the imaging examination or the operative findings. However, it is likely that the amebic infection occurred after a liver abscess ruptured into the abdominal cavity. Early diagnosis and therapy are required when an abscess of unknown origin borders the liver, given the possibility of amebic abscess.
Percutaneous catheter drainage in drug-resistant amoebic liver abscess.
This communication records our experience with the percutaneous catheter drainage (PCD) of 22 amoebic liver abscesses in 19 patients who had failed to respond to amoebicidal therapy. In one patient with a left lobe abscess, imminent rupture was an additional indication for drainage. PCD combined with amoebicidal therapy not only expedited recovery, but was curative in all 19 patients. There were no complications. We conclude that PCD is a most useful adjunct to drug therapy and recommend its routine use in the management of drug-resistant amoebic liver abscesses.
Pyogenic liver abscess--a neglected diagnosis.
Twenty-five patients with pyogenic liver abscess admitted to the Royal Brisbane Hospital between 1970 and 1982 have been reviewed. The mortality rate was 32%; however, all patients who were diagnosed before death survived. In seven patients there was a history of biliary obstruction or biliary surgery of whom six died. The mean age of the patients who died was significantly higher than those surviving and it is suggested that this resulted from overdiagnosis of malignancy in the elderly, some hesitancy in investigating older patients, and a tendency to attribute multiple space-filling defects to metastatic tumour. If liver biopsy or even exploratory laparotomy have failed to confirm the diagnosis of hepatic abscess the clinician should not discard the possibility. It is concluded that the continuing high mortality from liver abscess is in large part due to lack of clinical awareness and failure in diagnosis rather than to inadequate therapy.