Venous thrombosis and segmental hypoperfusion in amebic liver abscess: MDCT demonstration and its implications

Priyadarshi, Rajeev Nayan; Kumar, Pragya; Kumar, Ramesh; Anand, Utpal; Shyama,

doi:10.1007/s00261-020-02409-6

Cited by 9 publications

(14 citation statements)

References 25 publications

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“…The third factor may be the high prevalence of diffuse or wedge-shaped hypodensity in the type I abscesses, indicating widespread edema or ischemia [9,19]. In previous work, we have shown that the wedge-shaped hypoattenuating zone caused by portal or hepatic vein thrombosis are common in severe ALAs [19]. In this study, type I abscesses presented acutely, whereas type II or type III had delayed presentation.…”

Section: Discussionmentioning

confidence: 49%

“…Large size and multiplicity of the lesions are the two most important factors that can be assumed to have caused the increased severity of disease in this type. The third factor may be the high prevalence of diffuse or wedge-shaped hypodensity in the type I abscesses, indicating widespread edema or ischemia [9,19]. In previous work, we have shown that the wedge-shaped hypoattenuating zone caused by portal or hepatic vein thrombosis are common in severe ALAs [19].…”

Section: Discussionmentioning

confidence: 89%

“…After excluding 20 follow-up studies, 112 examinations were considered for final analysis. This study also included 43 patients from our previous study on venous thrombosis in ALA; this complication was not analyzed in this study [19]. Permission from the Institute Ethics Committee was obtained (AIIMS/Pat/IRC/2020/PGTh/July 19/15).…”

Section: Patient Populationmentioning

confidence: 99%

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CT of amebic liver abscess: different morphological types with different clinical features

et al. 2021

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 89%

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CT of amebic liver abscess: different morphological types with different clinical features

et al. 2021

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“…Type I pattern indicates an early and progressive abscess, with no sign of healing. Surrounding the abscess, there is a diffuse or wedge-shaped hypodensity, which is usually due to the combined effect of hypoperfusion and edema[ 10 , 68 ]. Most cases show irregular and interrupted enhancement at the edges.…”

Section: Imaging Evaluation: Imaging Classification and Clinicoradiol...mentioning

confidence: 99%

“…Venous thrombosis is a common phenomenon in this disease. Autopsy studies have shown that venous thrombosis occurs in up to 30% of cases; however, we have identified venous thrombus in 70% of cases with the use of the latest multidetector CT[ 42 , 68 ]. Venous thrombosis may involve the portal or hepatic vein, but usually both are involved.…”

Section: Complications: Clinico-radiological Findingsmentioning

confidence: 99%

Amebic liver abscess: Clinico-radiological findings and interventional management

Priyadarshi¹,

Kumar²,

Anand³

2022

WJR

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In its classic form, amebic liver abscess (ALA) is a mild disease, which responds dramatically to antibiotics and rarely requires drainage. However, the two other forms of the disease, i.e. , acute aggressive and chronic indolent usually require drainage. These forms of ALA are frequently reported in endemic areas. The acute aggressive disease is particularly associated with serious complications, such as ruptures, secondary infections, and biliary communications. Laboratory parameters are deranged, with signs of organ failure often present. This form of disease is also associated with a high mortality rate, and early drainage is often required to control the disease severity. In the chronic form, the disease is characterized by low-grade symptoms, mainly pain in the right upper quadrant. Ultrasound and computed tomography (CT) play an important role not only in the diagnosis but also in the assessment of disease severity and identification of the associated complications. Recently, it has been shown that CT imaging morphology can be classified into three patterns, which seem to correlate with the clinical subtypes. Each pattern depicts its own set of distinctive imaging features. In this review, we briefly outline the clinical and imaging features of the three distinct forms of ALA, and discuss the role of percutaneous drainage in the management of ALA.

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Liver Abscess in Children-experience From a Single Tertiary Care Center of North India

Lal¹,

Venkatesh²,

Kumar³

et al. 2021

Pediatric Infectious Disease Journal

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Background: Liver abscess (LA), a common problem in children in the tropics, is believed to be mostly pyogenic (PLA), sometimes amebic (ALA). We aimed to analyze the clinical profile, etiology, risk factors for complications, management and outcomes of LA in children. Methods:The details of 81 children with LA managed in a tertiary set up over a period of 3 years were analyzed. A comparison of different parameters was performed with respect to etiology and complications. Results: ALA, PLA and mixed infection LA were diagnosed in 40 (49.4%), 32 (39.5%) and 9 (11.1%) children. The triad of fever, hepatomegaly and right upper quadrant tenderness was seen in 65 (80.2%). Coagulopathy was observed in 60 (77%) and jaundice in 12 (14.8%). Majority (71.6%) had a single LA in the right lobe (69%). Conservative, percutaneous needle aspiration, percutaneous catheter drainage and surgical drainage were done in 11.1%, 3.7%, 82.7% and 2.5%, respectively. Forty-three (53.1%) had complicated LA with rupture in 55.8% and vascular thrombosis in 16.2%. Children with complicated LA had higher alanine transaminase, prolonged prothrombin time/international normalized ratio, low serum protein and albumin levels (P < 0.05). Median duration of follow-up was 2 months and mean time to resolution of LA was 48.5 ± 18 days. Conclusions: ALA is the commonest cause of pediatric LA in endemic regions and is difficult to differentiate from PLA clinically. Percutaneous catheter drainage is safe and effective modality for the management of LA in children. A higher alanine transaminase, prolonged prothrombin time/ international normalized ratio and low serum albumin levels (<3 g/dL) at presentation identify complicated LA.

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Venous thrombosis and segmental hypoperfusion in amebic liver abscess: MDCT demonstration and its implications

Cited by 9 publications

References 25 publications

CT of amebic liver abscess: different morphological types with different clinical features

CT of amebic liver abscess: different morphological types with different clinical features

Amebic liver abscess: Clinico-radiological findings and interventional management

Liver Abscess in Children-experience From a Single Tertiary Care Center of North India

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