Analogies in medicine: little thief in the skin

Andrade-Filho, José de Souza

doi:10.1590/s0036-46652012000200013

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…A pyogenic abscess is a walled-off collection of pus consisting of tissue debris and numerous inflammatory cells, primarily neutrophils [15]. Persistent inflammation leads to necrosis of surrounding tissue.…”

Section: Etiology and Pathophysiologymentioning

confidence: 99%

The Silent Killer: A Case Report of Delayed Diagnosis and Successful Treatment of Pancreatic Trauma

Coral

2023

oajs

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Hepatic abscesses are suppurated cavities caused by the invasion and multiplication of microorganisms within the liver parenchyma. This condition is relatively uncommon, with an estimated incidence of 2.3 to 3.6 cases per 100,000 people yearly. However, the incidence is higher in specific populations, such as patients with underlying liver disease, diabetes, or other immune-compromising conditions. The most common cause of liver abscesses is the spread of infection from other parts of the body, such as the biliary tract or gastrointestinal tract. Other causes include trauma to the liver, such as from a penetrating injury or surgery or the presence of a foreign body in the liver. Liver abscesses are broadly divided into two types: amoebic and pyogenic. The clinical presentation might vary, including fever, abdominal pain, nausea and vomiting, jaundice, and weight loss. In some cases, there may be no symptoms. Diagnosis typically involves an ultrasound or CT scan, which can show the presence of a fluid-filled mass in the liver. CT is the standard modality for diagnosis. Blood tests may also evaluate liver function and identify any underlying infections. Treatment typically involves a combination of antibiotics to target the underlying infection and drainage of the abscess. Supportive measures like hydration and pain management may also be necessary. In addition, close monitoring and follow-up are essential to ensure that the abscess has resolved and there are no complications. In some cases, surgical intervention may be necessary to remove the abscess or repair any damage to the liver. Liver abscess drainage is typically indicated in patients with significant, symptomatic abscesses or those who do not respond to medical treatment with antibiotics. In addition, abscesses at risk of rupturing or located close to vital structures, such as major blood vessels, may require drainage to prevent serious complications. Two drainage methods are presently available: non-surgical options, such as percutaneous needle aspiration or percutaneous catheter drainage, and surgical options, such as open drainage or laparoscopic drainage. This review identifies when these alternatives should be used, taking adverse effects, symptoms, and comorbidities into account.

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Section: Etiology and Pathophysiologymentioning

confidence: 99%

The Silent Killer: A Case Report of Delayed Diagnosis and Successful Treatment of Pancreatic Trauma

Coral

2023

oajs

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Liver abscess: diagnostic and management issues found in the low resource setting

Khim

et al. 2019

British Medical Bulletin

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Introduction Liver abscesses are mainly caused by parasitic or bacterial infection and are an important cause of hospitalization in low-middle income countries (LMIC). The pathophysiology of abscesses is different depending on the etiology and requires different strategies for diagnosis and management. This paper discusses pathophysiology and epidemiology, the current diagnostic approach and its limitations and management of liver abscess in low resource settings. Sources of data We searched PubMed for relevant reviews by typing the following keywords: ‘amoebic liver abscess’ and ‘pyogenic liver abscess’. Areas of agreement Amoebic liver abscess can be treated medically while pyogenic liver abscess usually needs to be percutaneously drained and treated with effective antibiotics. Areas of controversy In an LMIC setting, where misuse of antibiotics is a recognized issue, liver abscesses are a therapeutic conundrum, leaving little choices for treatment for physicians in low capacity settings. Growing points As antimicrobial resistance awareness and antibiotic stewardship programs are put into place, liver abscess management will likely improve in LMICs provided that systematic adapted guidelines are established and practiced. Areas timely for developing research The lack of a quick and reliable diagnostic strategy in the majority of LMIC makes selection of appropriate treatment challenging.

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Analogies in medicine: little thief in the skin

Cited by 2 publications

References 2 publications

The Silent Killer: A Case Report of Delayed Diagnosis and Successful Treatment of Pancreatic Trauma

The Silent Killer: A Case Report of Delayed Diagnosis and Successful Treatment of Pancreatic Trauma

Liver abscess: diagnostic and management issues found in the low resource setting

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