Falciform ligament abscess: report of a case Abscesso de ligamento falciforme: relato de caso

Falciform ligament abscess is rare. We report a case of a 65-year-old man who presented with right upper quadrant abdominal pain, postprandial fullness, and fever. Computed tomography disclosed a cylindrical mass in the anterior abdomen that aroused suspicion of a hepatic abscess. At laparoscopic surgery, an abscess of the falciform ligament was found and drained. Two months later, the patient developed recurrence of the abscess secondary to acute calculous cholecystitis. Abscess drainage and cholecystectomy were performed. The presence of right uppper quadrant abdominal pain, epigastric tenderness, fever, leukocytosis, and a mass in the anterior abdomen should arouse suspicion of falciform ligament abscess. Its treatment consists of abscess drainage.<br>Abscesso de ligamento falciforme é raro. É relatado um caso de um homem de 65 anos que apresentou dor no quadrante superior direito do abdome, plenitude pós-prandial e febre. A tomografia computadorizada revelou uma massa cilíndrica no abdome anterior que causou suspeita de abscesso hepático. Na cirurgia laparoscópica, um abscesso de ligamento falciforme foi encontrado e drenado. Dois meses depois, o paciente desenvolveu recidiva do abscesso secundário a colecistite aguda calculosa. Drenagem do abscesso e colecistectomia foram realizados. A presença de dor no quadrante superior direito, febre, leucocitose e abaulamento no abdome ântero-superior deve causar suspeita dessa patologia. Seu tratamento consiste de drenagem do abscesso

Engaging Teenagers with Science Through Comics

It is increasingly important for all citizens, and especially youth, to understand how viruses impact our health, communities and environment. Particularly for youth less interested in traditional science learning materials, comics may provide a way to engage teenagers with scientific information about viruses. We compared the impacts of different formats of educational materials on teenagers’ knowledge of, attitudes toward, and engagement with information about viruses. High school students (N = 873) were randomly assigned to read either a high quality comic or essay about viruses. Latent class analysis grouped youth into one of four categories that captured a range from low to high science identity. We compared material type (comic/essay) and science identity (low to high) on knowledge, attitudes and engagement. There were no comic/essay differences on knowledge, nor on attitudes about the importance of or interest in viruses. Across all levels of science identity, however, teenagers in the comic group were significantly more likely to want to read more similar materials than teenagers in the essay group, thus indicating more engagement. This effect was more pronounced among youth in the low compared to the higher identity categories. Our findings support the notion that comics can appeal to a wider audience of learners than traditional essays while still resulting in similar knowledge scores. This suggests that comics can be an important and effective tool to engage a broad spectrum of youth with science learning materials

Estudo comparativo dos procedimentos percutâneos orientados por métodos de imagem no tratamento das coleções hepáticas A comparative study of image-guided percutaneous procedures for the treatment of liver abscesses

OBJETIVO: Verificar e comparar a eficácia da punção aspirativa e da drenagem percutânea, orientadas por métodos de imagem, no tratamento das coleções hepáticas. MATERIAIS E MÉTODOS: Foram encaminhados, ao nosso setor, 52 pacientes para tratamento percutâneo de coleções abdominais. Destes, 17 apresentavam coleções hepáticas, sendo 13/17 não-complexas e 4/17, complexas (multiloculadas, múltiplas ou associadas a fístulas). Foram submetidas a punção aspirativa 7/17 coleções (41,2%) e a drenagem percutânea, 10/17 (58,8%). Considerou-se como sucesso do método a resolução completa da coleção, com melhora clínica e laboratorial do paciente. RESULTADOS: O sucesso do procedimento ocorreu em 82,4% dos casos. Nas coleções submetidas exclusivamente a punção aspirativa, obteve-se sucesso em 57,1%, enquanto nas submetidas a drenagem percutânea o sucesso foi de 100%. O índice de sucesso no grupo submetido a punção aspirativa foi de 75% nas coleções menores que 100 ml, e de 33,3% naquelas entre 100 e 250 ml. Houve sucesso com a punção aspirativa em 75% das coleções não-complexas e em 25% das complexas. CONCLUSÃO: A drenagem percutânea é mais eficaz que a punção aspirativa no tratamento das coleções hepáticas. A punção aspirativa talvez possa ser empregada como alternativa válida nas coleções de menor volume e não-complexas.<br>OBJECTIVE: To determine and compare the efficacy of percutaneous needle aspiration and percutaneous catheter drainage, both guided by imaging methods, for the treatment of liver abscesses. MATERIALS AND METHODS: From 52 patients referred to our service for percutaneous treatment of abdominal abscesses, 17 presented liver abscesses, 13 of which were considered noncomplex and four were considered complex (multiloculated, multiple or associated to fistulas). Percutaneous needle aspiration was performed in 7/17 patients and 10/17 patients were submitted to percutaneous catheter drainage. The method used was considered successful when there was complete abscess resolution with both clinical and laboratorial improvement. RESULTS: The procedures were successful in 82.4% of all cases. In the group submitted to percutaneous needle aspiration the rate of success was 57.1% and in the group submitted to percutaneous catheter drainage the rate of success was 100%. Successful treatment was achieved in 75% of the patients submitted to percutaneous needle aspiration for abscesses smaller than 100 ml, but in only 33.3% of the patients with abscesses between 100 and 250 ml. There was complete resolution of the abscesses with percutaneous needle aspiration in 75% of the simple abscesses and in 25% of the complex abscesses. CONCLUSION: Percutaneous catheter drainage is more effective than percutaneous needle aspiration for the treatment of liver abscesses. Needle aspiration may probably be used as a valid alternative for smaller and noncomplex abscesses