Abscesos hepáticos: análisis retrospectivo de 68 casos

Vega, García; Gutiérrez, Andrea Blanco; García, C; Plaza, A.; Jiménez, I. de la Riva

doi:10.4321/s0212-71992008000700005

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…Currently, a very specific technique which can be used for the diagnosis of ALA as long as the subject has not been treated with amoebacides is the presence of adhesin Gal-GalNac in the serum (27). The treatment of choice for PLA (echo or CT-guided percutaneous drainage in association with antibiotics) cures between 72 and 90% of patients, with complications ranging from 4 to 18% (28)(29)(30). The absolute contraindications for guided drainage are when there is an indication for surgery because of an associated disease or significant coagulopathy.…”

Section: Discussionmentioning

confidence: 99%

“…El tratamiento de elección en los AHP (drenaje percutáneo por ECO o TAC, asociado a antibióticos) proporciona la curación del 72 al 90% de los pacientes con una tasa de complicaciones del 4 al 18% (28)(29)(30). Las contraindicaciones absolutas para el drenaje dirigido son la necesidad de una laparotomía por el proceso de base y los trastornos de la coagulación.…”

Section: Discussionunclassified

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Pyogenic versus amoebic liver abscesses: A comparative clinical study in a series of 58 patients

Cosme

Ojeda²,

Zamarreño³

et al. 2010

Rev. esp. enferm. dig.

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Objective: to compare the clinical and epidemiological characteristics of patients with pyogenic liver abscess (PLA) and with amebic liver abscess (AHA) in order to determine the potential factors that may help improve diagnosis and treatment for this disease. Material and method: a retrospective study of clinical histories of 45 patients with PLA and 13 with ALA, diagnosed between 1985 and 2005 in Donostia Hospital in San Sebastián. Results: among the 45 patients with PLA (30 men and 15 women, with a mean age of 61 years and 11 months), more than a half were cholangitic (13 cases) or were of unknown origin (15 cases). In 10 patients, diabetes was considered to be a predisposing condition. Increased ESR (> 30), leukocytosis (> 12,000), fever and abdominal pain were observed in 95.5%, 86.7%, 82.8% and 68.9%, respectively. Twenty-five patients had single abscesses. Abscess and blood cultures were positive in 77.1% and 50% of cases, respectively (44.4% with polymicrobial infection). E. coli and S. milleri were the most commonly found germs. A percutaneous drainage was performed on 22 patients. Mean hospital stay was 27 days, and overall mortality, including that related to concomitant conditions, was 7 of 45 cases. Of the 13 cases of ALA (7 men and 6 women, with mean age of 42,9 years), 2 were locally acquired. Increased AF and GGTP (> 2N), fever, leukocytosis and ESR (> 30) were observed in 92.3, 77, 70 and 61.5% of cases, respectively. There were single abscesses in 10 patients and all except one were located in the right lobe. The serological test for E. histolytica (IFF ≥ 1/256) was positive in 100% of cases. A percutaneous drainage was carried out on 6 patients. Mean hospital stay was 18 days and two patients died. Conclusions: In our series, the clinical parameters suggesting pyogenic origin were: age 50 or older, male gender, diabetes, moderately elevated bilirubin and transaminases. In amoebic cases the associated features were being aged 45 or younger, diarrhoea, and presence of a single abscess in the right lobe. Parasitism by E. histolytica must be considered in the differential diagnosis of liver abscesses, even with no epidemiological clinical history of travel and/or immigration.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionunclassified

Pyogenic versus amoebic liver abscesses: A comparative clinical study in a series of 58 patients

Cosme

Ojeda²,

Zamarreño³

et al. 2010

Rev. esp. enferm. dig.

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Hemoperfusión con polimixina B en shock séptico secundario a abscesos hepáticos por Klebsiella pneumoniae

et al. 2012

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A liver abscess presenting as bowel obstruction and perforation

Rusman

2013

BMJ Case Reports

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SUMMARYA 69-year-old cachexic man presented with tachycardia and hypotension on a background of 7 days of vomiting and constipation. He was not obviously in pain. He had a raised white cell count of 24.8×10 9 /l, and a lactate of 2.2 mmol/l. A chest x-ray had the appearance of free air under the diaphragm and he was suspected of having a bowel obstruction with perforation. An abdominal CT scan showed instead a large fluid and gas-filled hepatic abscess, and a second smaller simple cyst. The abscess was percutaneously drained, and the purulent fluid drained grew Streptococcus milleri. The patient was discharged home 2 weeks later. BACKGROUND

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Abscesos hepáticos: análisis retrospectivo de 68 casos

Cited by 5 publications

References 13 publications

Pyogenic versus amoebic liver abscesses: A comparative clinical study in a series of 58 patients

Pyogenic versus amoebic liver abscesses: A comparative clinical study in a series of 58 patients

Hemoperfusión con polimixina B en shock séptico secundario a abscesos hepáticos por Klebsiella pneumoniae

A liver abscess presenting as bowel obstruction and perforation

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