Absceso hepático y enfermedad de Crohn. Presentación de 3 casos

Infante, Javier Molina; Cañizares, R. Bañares; Camarero, Judith Gómez; Calle, JL Pérez

doi:10.1157/13060693

Cited by 3 publications

(1 citation statement)

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“…Liver abscess is a rare complication of CD that has been elucidated in case reports and cohort studies [176,177]. Hepatic abscess could be an initial manifestation of CD [178,179].…”

Section: Hepatic Abscessmentioning

confidence: 99%

A review of liver disorders in inflammatory bowel disease (IBD)

Shah¹,

Gupta²,

Borg³

2017

Clin Case Rep Rev

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Disorders of the liver and the biliary tract are frequently the extraintestinal manifestations of inflammatory bowel disease (IBD). The etiology of these hepato-biliary conditions is deemed secondary to their shared pathogenesis, the chronic effects of a long term, ongoing inflammation of the bowels, along with the medications used to manage IBD. For up to 30% of patients with IBD, abnormal liver biochemical tests are present. Other, selected patients with IBD are followed for reactivation of hepatitis B, through guidelines only relatively recently in place. The vast realm of related clinical conditions does not always correspond well with IBD severity, which can range from mild hepatic insult to end-stage liver disease, necessitating liver transplantation. Hence it is critical to follow its presence, clinical course and long term consequences. Moreover, the management of these disorders is necessarily individualized, with some patients requiring frequent monitoring and others a more multi-disciplinary approach. Studies aimed at improving the outcomes of patients with IBD who experience associated liver and biliary tract disorders are now needed to assess early identification, possible screening approaches and more effective systems of referral. This article covers the evidence-based literature on topics detailing the co-existence of liver conditions in inflammatory bowel disease with a focus on its epidemiology, clinical manifestations, diagnosis and management.

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“…Liver abscess is a rare complication of CD that has been elucidated in case reports and cohort studies [176,177]. Hepatic abscess could be an initial manifestation of CD [178,179].…”

Section: Hepatic Abscessmentioning

confidence: 99%

A review of liver disorders in inflammatory bowel disease (IBD)

Shah¹,

Gupta²,

Borg³

2017

Clin Case Rep Rev

View full text Add to dashboard Cite

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Liver abscess due to Eikenella corrodens, Prevotella meloninogenica, and Lactobacillus spp. following pancreatoduodenectomy: Case report and review of the literature

et al. 2010

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Leberabszess durch Eikenella corrodens, Prevotella meloninogenica und Lactobacillus spp.Zusammenfassung. Grundlagen: Leberabszesse sind seltene Komplikationen bei Patienten, welche sich einer Pankreatektomie unterziehen. Eikenella corrodens ist ein Gram-negatives Stäbchen, welches bei Patienten mit Sepsis und Endokarditis isoliert wurde.Methodik: Wir berichten über einen Patienten, welcher 3 Monate nach Pankreatektomie und Polychemotherapie einen Leberabszess entwickelte. Drei untypische Erreger wurden nach Abszessdrainage isoliert. Bislang in der Literatur beschriebene Fälle von Leberabszessen mit Beteiligung dieser seltenen Erreger wurden zusammengefasst.Ergebnisse: Der 8 cm große Leberabszess wurde erfolgreich perkutan drainiert und Eikenella corrodens, Prevotella melaninogenica, and Lactobacillus spp. wurden aus dem Punktat isoliert. Die antibiotische Therapie umfasste initial Piperazillin=Tazobactam gefolgt von Ertapenem, und es kam innerhalb von 4 Wochen zur vollstän-digen Abheilung der schweren Infektion. Der Großteil bislang in der Literatur beschriebener Leberabszesse mit Beteiligung dieser Erreger wurde mittels perkutaner Drainge und gezielter antibiotischer Therapie erfolgreich behandelt. Eikenella corrodens (n ¼ 10) and Prevotella (n ¼ 8) wurden typischerweise bei polymikrobiellen Infektionen isoliert, während Lactobacillus (n ¼ 6) Leberabszesse häufig monomikrobiell waren.Schlussfolgerungen: Patienten, welche sich einer Pankreasresektion unterziehen und eine Chemotherapie erhalten, haben ein erhöhtes Infektionsrisiko. Seltene Krankheitsbilder wie Leberabszesse und seltene Erreger wie Eikenella corrodens sollten differentialdiagnostisch in Erwägung gezogen werden. Bei entsprechend frühzei-tiger Erkennung und adäquater Behandlung können diese Komplikationen durchaus erfolgreich behandelt werden.Schlüsselwörter: Leberabszess, Pankreaskarzinom, Pankreasresektion, Eikenella corrodens.Summary. Background: Liver abscess may be a complication after pancreatectomy. Eikenella corrodens is a rare pathogen associated with sepsis and endocarditis among other infections.Methods: We report on a patient who developed a polymicrobial liver abscess with three unusual pathogens three months following pylorus preserving pancreatoduodenectomy and adjuvant chemotherapy for pancreatic adenocarcinoma. A review of the literature with regard to liver abscesses caused by the rare pathogens was performed.Results: The eight cm pyogenic liver abscess, which grew Eikenella corrodens, Prevotella melaninogenica, and Lactobacillus spp., was successfully treated with percutaneous drainage and antibiotic therapy using piperacillin=tazobactam followed by ertapenem. Literature review for previously reported cases of liver abscesses due to these organisms revealed that most were percutaneously drained and had good outcome. Eikenella corrodens (n ¼ 10) and Prevotella (n ¼ 8) liver abscesses were typically polymicrobial, whereas Lactobacillus (n ¼ 6) liver abscesses were more commonly monomicrobial.

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