Inferior vena caval and right atrial thrombus complicating amoebic liver abscess: Table 1:

Abstract

We present the result of right atrial thrombectomy in a paediatric patient suffering from a right atrial thrombus due to amoebic liver abscess under total circulatory arrest. A 2-year old boy with amoebic liver abscess complicated by inferior vena cava (IVC) thrombus extending up to the right atrium (RA) was operated on in our institute. During the surgery, the thrombus was removed from the IVC and the RA under deep hypothermic circulatory arrest. After chest closure, open drainage of the abscess was performed. Metronidazole was given postoperatively for 2 weeks. The postoperative period was uneventful. There was rapid convalescence with complete resolution of the abscess. Anticoagulation with warfarin was started on the day following surgery and continued for 6 weeks. There was no recurrence of thrombosis or embolic events in the follow-up period. Extension of thrombus into the right atrium mandates an aggressive surgical approach which may prove life saving. It is crucial in the prevention of pulmonary embolism or Budd-Chiari syndrome, which may have an overall poor outcome.

Occult Amebic Liver Abscess as Cause of Extensive Inferior Vena Cava and Hepatic Vein Thrombosis

“…4 Other case reports document similarly large amebic abscesses in the setting of thrombus. [5][6][7][8][9] The association of thrombus and large ALA is in accordance with the proposed mechanism of thrombus development: mechanical compression and active inflammation. Our case suggests that mechanical compression is not necessary for the development of thrombus, and emphasizes the thrombogenic potential of amoebiasis.…”

“…IVC and hepatic thrombosis is a rare complication of ALA mainly described in case reports. [3][4][5][6][7][8][9] Our case is unique in that it is the first to demonstrate the presence of extensive IVC and hepatic thrombosis secondary to an ALA that was initially occult on imaging. Ray and others reported a case in India where a 15-× 10-cm collection was found on ultrasound abutting the IVC with associated thrombus.…”

“…2 Thrombosis is a rare complication of ALA mainly documented in case reports. [3][4][5][6][7][8][9] The mechanism of thrombosis has been primarily explained by mechanical compression of the vascular structures and localized inflammation. 3,10…”

Parasitic Infections in Pediatric Population of India: Epidemiology, Diagnosis, and Strategies for Prevention

“…[42][43][44] However, few sporadic cases have also been reported from Bihar, West Bengal, Manipur, Orissa, Tamil Nadu, and Karnataka. [45][46][47][48][49][50][51][52][53][54][55][56][57][58] Highest burden was shown to be in children due to eating raw lotus flower buds and tubers, which are contaminated by this parasite. 43,44,49,50 A couple of reports are on records of Metagonimus infection among pediatric patients from Assam and recently from Delhi.…”

“…54 In some of the studies, it was shown that uniloculated solitary right lobe abscess was a common clinical presentation among children. [55][56][57][58] Liver Fluke (Fasciola sp. )…”