A note on clinical presentations of amebic liver abscess: an overview from 62 Thai patients

BACKGROUND: Amebic liver abscess is a tropical disease with a wide spectrum of clinical presentations. Given the often nonspecific nature of the complaints related to amebic abscess, a retrospective review of patients with confirmed disease to recognize the most common patterns of presentation is useful. Here, we study the clinical presentations of 62 Thai patients with amebic liver abscess. We also compare the clinical presentations of Anti HIV seronegative and Anti HIV seropositive patients. METHODS: A retrospective case review was carried out for 62 Thai patients who had been diagnosed with amebic liver abscess. Clinical information was collected, including symptoms and signs, location and number of abscesses. The Anti HIV serology laboratory investigation was also reviewed. RESULTS: According to our study, the common clinical symptoms and signs are abdominal pain (85.5 %), fever and chills (74.2 %), and abdominal tenderness (69.4 %). The location of the abscess was predominantly in the right lobe (74.2 %), and most of patients had a single abscess (77.4 %). Similar trends in clinical presentations were observed in both Anti HIV seropositive and Anti HIV seronegative subjects. CONCLUSIONS: In conclusion, the clinical presentations of our amebic liver abscess patients were similar to those in previous reports. A similarity to those in the pyogenic liver abscess patients can be observed. Nevertheless, we could not detect important significant differences in the clinical presentations between Anti HIV seropositive and Anti HIV seronegative groups of patients

Venous spread of renal cell carcinoma: MDCT

BACKGROUND: The purpose of our study was to present multidetector computed tomography (MDCT) findings in venous spread of renal cell carcinoma (RCC), to determine the superior extent of tumor thrombus and to compare MDCT findings with surgical report. ----- METHODS: The prospective MDCT study was performed on 31 patients diagnosed with RCC with venous spread (19 males and 12 females; age range 39-80 years; mean age 62.6 years). CT scans were obtained by MDCT scanner, in triphasic scanning protocol. All postprocessing techniques were performed by two independent radiologists, and the findings were reported in their consensus. MDCT diagnosis was compared with surgical and pathohistological findings. ----- RESULTS: Tumor thrombus extension into renal vein only (T3b stage) was found in 13/31 (42%) patients. Involvement of infradiaphragmatic level of inferior vena cava (IVC) (T3c stage) was found in 14/31 (45%) patients and supradiaphragmatic level of IVC (T4b stage) in 4/31 (13%) patients. In 27/31 (87%) patients surgery was performed, while 4/31 (13%) could not undergo surgery. In comparison with surgical report, in 25/27 (93%) operated patients the upper extent of the tumor thrombus was correctly diagnosed by MDCT, and 2/27 (7%) patients were falsely diagnosed. ----- CONCLUSION: MDCT represents a fast, relatively inexpensive, and reliable diagnostic method for evaluating the venous spread of RCC as well as the level of its upper extent. Triphasic MDCT is often the only diagnostic method necessary for planning the surgical procedure. Surgery should be performed as soon as possible for MDCT findings to be valid