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

Problems in Diagnosis Approach for Carcinoma of Pancreatic Head

Incidences of pancreatic cancer worldwide have been known to be increased. It is the fifth leading cause of death in United State of America. Seventy percent occurs in the head of the pancreas. Major risk factors are related to age, black race, smokers, high-fat diet, chronic pancreatitis, diabetes mellitus and alcohol consumption. Some clinical symptoms such as jaundice, abdominal pain, unexplained weight loss or ascites can occur early or even late in the course of disease. Diagnosing pancreatic cancer sometimes can be difficult, regarding to discrepancy between clinical symptoms and radiological findings. It is important to take good history of the patient, thorough examination, and combine several modalities in diagnosing tumor of pancreatic head. In this case report, a 54 year-old female, came to the hospital with abdominal swelling and jaundice. Physical examination revealed liver and spleen enlargement and edema on both lower extremities. The laboratory result showed increment in Carcinoembryonic Antigen (CEA) and carbohydrate antigen 19-9 (CA19–9) level, without marked increase in bilirubin level. Dilatation of the pancreatic duct was found in this patient, without any sign of bile stone. Endoscopic Retrograde Cholangiopancreatography (ERCP) in this patient was failed to have significant result