Liver Abscesses: a 10-year Vinnytsya University Study

According to MEDLINE database there were about 1278 papers on liver abscess published in a period from 2001 to 2015.The aim of the study is to improve liver abscess treatment results comparing minimally invasive and traditional operative techniques.Materials and methods. 137 patients were included in the study and divided on two comparison groups. Traditional methods were used for the treatment of 66 participants of the control group (48.2 %). For 71 patients (51.8 %) of the general group the mini-invasive drainages were predominating.Results. Cholangiogenic causes of liver abscesses were found in 41 patients (29.93±3.91 %), cryptogenic ones – in 37 (27.01±3.79 %), haematogenous causes – in 29 (21.17±3.49 %), contact ones – in 16 (11.68±2.75 %), posttraumatic ones – in 11 (8.03±2.32 %) and purulent destruction of metastases – in 3 (2.19±1.25 %).Single abscesses occurred more often – in 117 (85.40±3.02 %), multiple once – in 20 (14.60±3.02 %). Mostly 3, 6 and 7 liver segments were damaged – 19 (13.88±2.95 %), 35 (25.55±3.73 %), 44 (32.12±3.99 %).In control group, the abscess drainage via laparotomy was performed on 58 patients (87.88±4.02 % of 66 ones) versus 21 (29.58±5.42 % of 71 ones) in general group. Percutaneous drainage was used in 8 (12.12±4.02 %) and in 44 (61.97±5.76 %) cases respectively. 6 or 8.45±3.30 % laparoscopic interventions were used only in the general group. Finally, mini-invasive drainages were applied in the greater part of general group - 50 (70.42±5.42 %) versus 8 ones (12.12±4.02 %) in control group.Conclusions. Minimally invasive liver abscess drainages showed a significant reduction of postoperative complications from 24.24±5.27 % in the control group to 12.66±3.95 % in the general group, shortening of hospital terms from 14.6±1 in control to 5.2±0.8 days and decreasing of mortality from 7.58±3.26 % to 2.82±1.96 %

Pyogenic Liver Abscess Following an Uncomplicated Colonoscopy

Pyogenic liver abscess is a potentially devastating clinical entity associated with significant morbidity and mortality[1]. A myriad of causes for liver abscess have been described including intra-abdominal infections such as diverticulitis[2]. Due to a non-specific presentation, clinicians often require a high level of suspicion in their diagnosis of this condition. A handful of cases of liver abscess have been described following colonoscopy which was usually a complicated procedure or one where multiple biopsies had been taken[3,4]. The case of a patient presenting pyrexia of unknown origin one week after undergoing an uncomplicated colonoscopy in which no biopsies were taken is reported. She was ultimately diagnosed with a pyogenic liver abscess

Management of Pyogenic Liver Abscess and Empyema as Its Complication

Pyogenic liver abscess may have serious complications that need specific management. We reported a case of a young male patient aged 24 years old and complained of abdominal enlargement since 2 (two) weeks before. Abdominal ultrasound revealed multiple liver abscesses. Liver aspiration was performed and about 500 cc of yellowish purulent fluid was drained. During hospitalization the symptoms of fever and shortness of breath were getting worse although adequate antibiotic treatment had been given. Chest X-ray examination showed elevated right hemidiaphragm and right pleural effusion. Thoracocentesis and proof puncture showed purulent fluid. He was diagnosed with empyema as a complication of pyogenic liver abscess. Water Sealed Drainage (WSD) was performed to evacuate the fluid and he was given antibiotics. The patient\u27s condition improved in several days

The Development of a Liver Abscess after Screening Colonoscopy: A Calculated Risk?

We present the case of a patient who developed a liver abscess following screening colonoscopy. A colorectal screening program was introduced in the Netherlands in 2014 in order to reduce mortality from colorectal cancer. The patient in this report, a 63-year-old man with no significant medical history, underwent polypectomy of two polyps. Four days afterwards he presented to our emergency department with fever, nausea and vomiting. He was diagnosed with a Klebsiella pneumoniae liver abscess and was successfully treated with antibiotics for 6 weeks. This case highlights one of the risks of screening colonoscopy. Given the high number of colonoscopies due to the colorectal screening programs, we should be aware of complications in this mostly asymptomatic group of patients

STAPHYLOCOCCUS AUREUS RESISTENTE À METICILINA E ABCESSO HEPÁTICO Análise Retrospectiva de 117 Casos

Introdução: Os abcessos hepáticos constituem uma entidade clínica que coloca desafios no diagnóstico e tratamento, sendo em muito casos necessário um elevado índice de suspeição. A maioria dos abcessos hepáticos piogénicos são polimicrobianos. Os agentes entéricos facultativos e anaeróbios são os mais comuns. Na literatura revista, os abcessos hepáticos a Staphylococcus aureus constituem cerca de 7% dos abcessos hepáticos piogénicos. Esta infecção habitualmente resulta de disseminação hematogénea de microrganismos isolados em infecções à distância. Não existem séries publicadas sobre esta matéria, sendo que a informação disponível se restringe a case-reports. Objectivo e Métodos: Com o objectivo de aprofundar a fisiopatologia, diagnóstico e história natural dos abcessos hepáticos, nomeadamente por Staphylococcus Aureus resistente à meticilina (MRSA), realizou-se um estudo retrospectivo, fazendo a revisão do processo clínico dos doentes com o diagnóstico de abcesso hepático/piemia portal entre Janeiro de 2004 e Dezembro de 2009, num total de 117 doentes. Resultados: Clinicamente, a maior parte dos doentes tinha febre e dor abdominal. A esmagadora maioria dos doentes não dispensou TC abdominal no diagnóstico. Apenas 81,2% dos doentes realizaram algum tipo de colheita para microbiologia. O agente mais frequentemente isolado foi a Escherichia coli. O MRSA estava presente em 7,6% dos abcessos cujo pús foi processado. A terapêutica mais frequentemente seleccionada foi a drenagem percutânea associada a antibioterapia. Todos os MRSA isolados eram sensíveis ao trimetoprim-sulfametoxazol e vancomicina. O grupo de patologia subjacente mais frequentemente encontrada foi o das doenças das vias biliares, seguido dos pós-operatórios recentes. Na esmagadora maioria das infecções a MRSA, o grupo de patologia subjacente mais frequentemente encontrada foi o pós-operatório abdominal. A taxa de mortalidade global foi de 17,9%. No que respeita a abcessos a MRSA, faleceu 1 doente devido a complicações da doença de base. Conclusões: Estes dados confirmam que o MRSA é um patogénio importante em infecções hospitalares, incluindo as intra-abdominais. É de salientar a importância do pós-operatório abdominal como factor de risco para infecção por este agente, um dado pouco descrito na literatura revista. Estes achados acarretam implicações assinaláveis a nível terapêutico, investigacional e prognóstico

Hypermucoviscous Klebsiella pneumoniae liver abscess in a previously healthy Burmese male

We report the case of a 38 year-old previously healthy Burmese man who presented with abdominal pain, headache, myalgia, and back pain. He was found to have leukocytosis, transaminitis, hyperbilirubinemia, and evidence of systemic inflammation. A hypodense hepatic mass was identified with a CT of the abdomen. The patient was ultimately diagnosed with hypermucoviscous K. pneumoniae CA-PLA. This case provides additional evidence for the emergence of hypermucoviscous K. pneumoniae CA-PLA outside of East Asia and supports the need for continued research to gain a better understanding of its pathogenesis predilection for individuals of Asian decent. This report also delineates the importance of acknowledging the dynamic state of infectious disease, the shifting racial demographics in the Western world, and the ever-present potential for antibiotic resistance. With this information clinicians will be more equipped to identify and treat a potentially fatal disease in individuals with symptoms of a seemingly self-limiting infection