scholarly journals Amoebic liver abscess in a COVID-19 patient: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea L. Maricuto ◽  
Viledy L. Velásquez ◽  
Jacinto Pineda ◽  
David M. Flora-Noda ◽  
Isaac Rodríguez ◽  
...  
Keyword(s):  
Liver Abscess ◽  
Abdominal Cavity ◽  
Exploratory Laparotomy ◽  
Abdominal Ultrasound ◽  
Amoebic Liver Abscess ◽  
Stool Examination ◽  
Nasopharyngeal Swab ◽  
Suspected Case ◽  
Middle Income ◽  
Patient Reported

Abstract Background Amoebiasis is a parasitic disease caused by Entamoeba histolytica, which affects people living in low- and middle-income countries and has intestinal and extraintestinal manifestations. To date, knowledge on coronavirus disease 2019 (COVID-19) coinfection with enteric parasites is limited, and E. histolytica coinfection has not been previously described. Here we present the case of a patient with COVID-19 who, during hospitalisation, presented a clinical picture consistent with an amoebic liver abscess (ALA). Case presentation A 54-year-old man, admitted as a suspected case of COVID-19, presented to our hospital with dyspnoea, malaise, fever and hypoxaemia. A nasopharyngeal swab was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse-transcription polymerase chain reaction. After 7 days, he developed diarrhoea, choluria and dysentery. An abdominal ultrasound showed a lesion compatible with a liver abscess; stool examination revealed E. histolytica trophozoites, and additional serology for E. histolytica was positive. After 12 days of treatment with metronidazole, ceftazidime and nitazoxanide, the patient reported acute abdominal pain, and an ultrasound examination revealed free liquid in the abdominal cavity. An emergency exploratory laparotomy was performed, finding 3000 mL of a thick fluid described as “anchovy paste”. Computed tomography scan revealed a second abscess. He ended up receiving 21 days of antibiotic treatment and was discharged with satisfactory improvement. Conclusion Here we present, to the best of our knowledge, the first report of ALA and COVID-19 co-presenting. Based on their pathophysiological similarities, coinfection with SARS-CoV-2 and E. histolytica could change the patient’s clinical course; however, larger studies are needed to fully understand the interaction between these pathogens.

scholarly journals ANALISIS PEMERIKSAAN LABORATORIUM PADA KASUS LEPTOSPIROSIS DISERTAI ABSES HATI AMOEBA

2021 ◽  
Vol 3 (3) ◽  
pp. 131-139
Author(s):  
Donaliazarti Donaliazarti
Keyword(s):  
Liver Abscess ◽  
Clinical Manifestations ◽  
Abdominal Ultrasound ◽  
Amoebic Liver Abscess ◽  
Personal Hygiene ◽  
Serological Examination ◽  
Mild Anemia ◽  
Prolonged Aptt ◽  
The Right ◽  
Time Of Admission

Leptospirosis is a disease caused by spirochaeta microorganism of the genus Leptospira, while the amoebic liver abscess is an extraintestinal complication by Entamoeba Histolytica. Both diseases occurred in a 45-year-old man with poor personal hygiene and environment sanitation. Amoebic liver abscess was found to be a coincidence that was thought to have existed before the patient developed leptospirosis so that the two diseases caused overlapping clinical manifestations in the patient, but the acute symptoms experienced by the patient at the time of admission were more likely to be caused by his leptospirosis. Patient complained of high fever, yellowing of the skin and eyes, urinating like concentrated tea, stiffness in both legs, nausea, vomiting and heartburn. On physical examination found febrile, tachycardia, icteric on skin and sclera, ciliary injection, and hepatomegaly. Laboratory tests showed mild anemia with normocytic normochromic features, leukocytosis with neutrophilia shift to the right, thrombocytosis, increased ESR, prolonged APTT, hyperbilirubinemia, elevated SGOT SGPT, ALP and GGT enzymes, hypoalbuminemia, hyperglobulinemia, and bilirubinuria. Microscopic examination with negative staining of urine samples found Leptospira. Abdominal ultrasound examination showed a solitary space occupying lesion (SOL) in the right lobe of the liver and on serological examination showed positive antiamoeba. Based on the above, this patient was diagnosed as having coincident leptospirosis with amoebic liver abscess.

scholarly journals A case report of ruptured amoebic liver abscess causing cardiac tamponade and requiring pericardial window

2020 ◽  
Vol 4 (5) ◽  
pp. 1-4
Author(s):  
Cliojis Francis ◽  
Swati Soni ◽  
Anunay Gupta ◽  
Sourabh Agstam
Keyword(s):  
Cardiac Tamponade ◽  
Liver Abscess ◽  
Rare Complication ◽  
Abdominal Ultrasound ◽  
Left Lobe ◽  
Amoebic Liver Abscess ◽  
Chest Drain ◽  
Pericardial Window ◽  
Extraintestinal Manifestation ◽  
Window Management

Abstract Background Amoebiasis is a prevalent infection in the tropics. Amoebic liver abscess is the most common extraintestinal manifestation. Cardiac tamponade is an uncommon complication of amoebic liver abscess that may need urgent pericardiocentesis. Case summary A 25-year-old man presented with abdominal pain and fever for 1 month. Abdominal ultrasound revealed a 4.7 × 4.7 cm abscess in the left lobe of the liver. Percutaneous pigtail drainage was performed to evacuate the abscess. After 2 days, the patient developed signs of cardiac tamponade and bilateral pleural effusion, requiring urgent pericardiocentesis and chest drain insertion. Persistent posterior collection of thick abscess in pericardium needed pericardial window for complete drainage. The patient recovered completely after pericardial window. There was no evidence of chronic constrictive pericarditis after 1 year of follow-up. Discussion A rare complication of the amoebic liver abscess was observed in this young adult who developed cardiac tamponade, requiring an urgent pericardiocentesis, and later requiring pericardial window. Management includes amoebicidal and luminicidal drugs for complete eradication of Entamoeba histolytica.

scholarly journals Giant Fibrothecoma of the Ovary in a Young Patient a Case Report

2021 ◽  
pp. 1-3
Author(s):  
Martínez Rodas O ◽  
Keyword(s):  
Clinical Presentation ◽  
Abdominal Cavity ◽  
Pelvic Mass ◽  
Exploratory Laparotomy ◽  
Abdominal Ultrasound ◽  
Free Fluid ◽  
Stromal Tumors ◽  
Menopausal Women ◽  
Space Compression ◽  
Post Menopausal

Fibrothecomas are benign ovarian stromal tumors, they are rare tumors of gonadal stromal cell origin that represent 3-4% of all ovarian tumors. It commonly occurs in post-menopausal women. The clinical presentation is often nonspecific, whereas patients more frequently present with a pelvic mass, metrorrhagia, and pelvic pain. We present a 35-year-old patient, nulli-pregnant, with no personal or family pathological history, who attended a medical consultation for presenting progressive abdominal distention of 6 months of evolution in addition to abdominal pain in the last 2 months type colic which increased during her menstrual periods concomitantly alteration in your defecatory habits. Abdominal ultrasound was performed, finding a solid intrapelvic mass of approximately 14x10x10 cm in diameter of probable left ovarian origin, free fluid in the Douglas space, compression and displacement of intestinal loops and bladder. The patient underwent surgery and an exploratory laparotomy was performed, finding a pelvic tumor adhered to the tube and left ovary, in addition to ascites fluid in the abdominal cavity, complete resection of the tumor, ovary and left salpingue was performed.

scholarly journals Intestinal Rupture Due to a Non-Perforating Foreign Body

2020 ◽  
Vol 48 ◽  
Author(s):  
Fabiana Cardoso Gomes ◽  
John Willer Carvalho Anunciação ◽  
Paula Elisa Brandão Guedes ◽  
Renata Santiago Alberto Carlos
Keyword(s):  
Alkaline Phosphatase ◽  
Foreign Body ◽  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
Exploratory Laparotomy ◽  
Abdominal Ultrasound ◽  
Oral Solution ◽  
Vitamin Supplement ◽  
Biochemical Tests ◽  
Abdominal Drain

Background: Intestinal obstruction by a foreign body is a common occurrence in domestic animals, needing the attention of veterinarians and owners, given that a serious complication of this condition is intestinal rupture, with consequent peritonitis. Perforating objects are the ones most often associated with rupture, but any object that obstructs the intestinal tract, if not removed properly, can lead to intestinal rupture, generating a poor prognosis. This article reports a case of intestinal rupture caused by a non-perforating foreign body in a dog. Case: A 1-year-old Chow-Chow dog was taken by its owner to the Portal Pet private clinic, with a history of foreign body ingestion and emesis. The owner reported that he took the animal to veterinary care in another establishment on the day he noticed vomiting, with no other abnormality being detected. An injectable medication was administered, but the owner did not know what it was, and the dog was discharged. After 15 days, the owner sought care at the clinic initially mentioned, due to the persistence of emesis, in addition to the onset of diarrhea and apparent apathy. On physical examination, the dog was apathetic, with pale mucosa and pain on abdominal palpation. A firm structure was felt, located in the epigastric region, compatible with a foreign body. The dog was referred for hospitalization and an abdominal ultrasound was requested, in addition to blood samples for hematological and serum biochemical tests (urea, creatinine, alanine aminotransferase, and alkaline phosphatase). Serology for parvovirus was also performed. The blood count revealed leukopenia (4,800 thousand/mm3) and biochemical analysis showed an increase in alkaline phosphatase (895.5 U/l). The results for parvovirus were negative. Ultrasonography confirmed the presence of a foreign body. The animal was referred for exploratory laparotomy, in which the foreign body was found in the abdominal cavity as a result of intestinal rupture, and peritonitis was observed. The foreign body was removed, the abdominal cavity washed, intestinal raffia made, and an abdominal drain inserted. The foreign body was identified as a silicone makeup sponge. Three days later, the drain was removed. The patient had good post-surgical clinical evolution and was discharged. The prescription given was as follows: omeprazole 1 mg/kg (VO, every 24 h in the morning, for 2 weeks); dipyrone25 mg/kg (VO, TID, for 4 days); cephalexin 25 mg/kg (VO, BID, for 10 days); mineral vitamin supplement based on probiotics and prebiotics 1 tablet/10 kg (VO, every 24 h, for 10 days); vermifuge based on milbemycin oxime and praziquantel 5-25 mg (VO, in a single dose, with repetition after 15 days); enrofloxacin 50 mg 10 mg/kg (VO, every 24 h, for 7 days); immunoglobulinbased on blood plasma, vitamins and minerals 1 tablet/10 kg (VO, BID, until new recommendations); and metronidazole 40 mg/mL oral solution at a dose of 25 mg/kg (VO, BID, for 7 days). As topical treatment, an antiseptic spraybased on laurel, diethylene glycol ether, sodium sulfate, and povidine iodinewas prescribed for surgical wound cleansing, until the suture removal, and the use of a surgical collar was requested. A reassessment was scheduled after 10 days, during which the suture was removed. At this point the dog had fully recovered.Discussion: Intestinal obstruction by a foreign body is a common cause of veterinary emergencies. As observed in the reported case, rupture of the intestinal wall and peritonitis can result. Although the prognosis of the affected animals is guarded, diagnosis prior to the worsening of septicemia as well as immediate surgical intervention were essential for recovery.      

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

2019 ◽  
Vol 132 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Gaetan Khim ◽  
Sokhom Em ◽  
Satdin Mo ◽  
Nicola Townell
Keyword(s):  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Diagnostic Strategy ◽  
Middle Income ◽  
Low Resource ◽  
Liver Abscesses ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Low Middle Income Countries

Abstract 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.

scholarly journals Ovarian and Uterine Horn Agenesis Accompanied by Ectopic Fetal Mummifcation in Canine

2016 ◽  
Vol 44 (1) ◽  
pp. 5
Author(s):  
Thalita Priscila Peres Seabra Da Cruz ◽  
Samara Rosolem Lima ◽  
David Ronald Parra Travagin ◽  
Caroline Argenta Pescador ◽  
Roberto Lopes De Souza
Keyword(s):  
Complete Blood Count ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Uterine Cavity ◽  
Exploratory Laparotomy ◽  
Abdominal Ultrasound ◽  
Uterine Horn ◽  
Mato Grosso ◽  
Mating History ◽  
Veterinary Hospital

Background: The uterine horn agenesis or aplasia is a rare anomaly consisting of absence or incomplete development of the paramesonephric ducts that origin the uterine horns. This change occurs during fetal formation and may occur concomitantly to agenesis of the ovary and/or ipsilateral kidney. The extra-uterine pregnancy consists of fetal growth outside the uterine cavity and can occur as a tubal or abdominal pregnancy. We report here the case of a 7-years-old mix breed dog, attended at the Veterinary Hospital of the Federal University of Mato Grosso, with accidental diagnosis of agenesis of uterine horn and ovaries and ectopic fetal mummifcation.Case: A 7-years-old mix breed dog, not spayed, was attended at the Veterinary Hospital of the Federal University of Mato Grosso (HOVET-UFMT), complaining of mucous bloody vaginal discharge. The patient had regular estrus and was multiparous. There was no mating history in the last estrus neither trauma over the past months. In previous pregnancies the patientpresented eutocic labors. On physical examination the dog showed apathy although it was alert, pale mucous membranes, presence of perivulvar blackish secretion and discreet abdominal enlargement. As preoperative exams, a complete blood count, liver and renal function (serum creatinine and alanine aminotransferase) were performed. It has also performedthe abdominal ultrasound examination, which revealed the presence of uterus flled with hypoechoic luminal content and a thickened and irregular wall. The patient was referred to therapeutic ovariohysterectomy (OHE). After anesthesia and antisepsis, the access to the abdominal cavity was made, where there was a mummifed fetus with approximately 15.5 cmfrom neck to tail set, equivalent to 57 days of gestation. After removal of the papyraceus fetus, the uterus was found and then, when exposed, there was only the left uterine horn flled by content and ovarie, both were removed. After inspection, the synthesis of the abdominal cavity was carried out as the routine. During the postoperative period, the patient had no complications or other clinical signs similar to those observed in the initial presentation. Antibiotic (enrofloxacin 5 mg/kg every 12h), analgesic (dipyrone 20 mg/kg every 8 h) and non-steroidal anti-inflammatory (meloxicam 0.2 mg/kg every 24 h) were prescribed. The fetus and uterus were sent to the Veterinary Pathology UFMT Laboratory (PVL-HOVET).The fetus was covered by omentum and fat. After the initial incision, there was a hard fbrous capsule surrounding the mummifed fetus. There were no recent signs of rupture or scarring resulting from previous trauma in the uterus. Its size was 15x4.8x2.8 cm and it was flled out with mucus bloody brownish secretion (pyometra). Microscopically, had purulent inflammatory infltrate, diffuse and severe in mucosa and submucosa associated with cell debris and moderate hyperplasia glands containing microabscesses inside.Discussion: Reports of extra-uterine fetal mummifcation in dogs and cats are scarce. Even being reported infrequently in dogs if congenital uterine and ovarian abnormalities are found during surgery, a detailed inspection of the abdominal cavity should be performed in order to rule out the possible presence of the ipsilateral ovary. Even with the lack of specifc clinical signs, fetal ectopy can be diagnosed through a detailed clinical examination and image exams. Exploratory laparotomy can be used as a diagnostic and therapeutic tool, since the treatment is the excision of ectopic tissue and OHE in cases of uterine rupture.Keywords: aplasia, fetus, mummifcation, unicornuate uterus.

scholarly journals Emergency Surgery during COVID-19: Lessons Learned

2020 ◽  
Vol 06 (03) ◽  
pp. e167-e170
Author(s):  
Hemanga K. Bhattacharjee ◽  
Shafneed Chaliyadan ◽  
Eshan Verma ◽  
Keerthi Kumaran ◽  
Priyank Bhargava ◽  
...  
Keyword(s):  
Stable Condition ◽  
Exploratory Laparotomy ◽  
Sigmoid Volvulus ◽  
Lessons Learned ◽  
Suspected Case ◽  
Surgical Emergencies ◽  
Viral Particles ◽  
Hospital Patients ◽  
Perforation Peritonitis ◽  
Precautionary Measures

Abstract Introduction The ongoing coronavirus disease-2019 (COVID-19) pandemic has disrupted health services throughout the world. It has brought in several new challenges to deal with surgical emergencies. Herein, we report two suspected cases of COVID-19 that were operated during this “lockdown” period and highlight the protocols we followed and lessons we learned from this situation. Result Two patients from “red zones” for COVID-19 pandemic presented with acute abdomen, one a 64-year male, who presented with perforation peritonitis and another, a 57-year male with acute intestinal obstruction due to sigmoid volvulus. They also had associated COVID-19 symptoms. COVID-19 test could not be done at the time of their presentation to the hospital. Patients underwent emergency exploratory laparotomy assuming them to be positive for the infection. Surgical team was donned with full coverall personal protective equipment. Sudden and uncontrolled egression intraperitoneal free gas was avoided, Echelon flex 60 staplers were used to resect the volvulus without allowing the gas from the volvulus to escape; mesocolon was divided using vascular reload of the stapler, no electrosurgical devices were used to avoid the aerosolization of viral particles. Colostomy was done in both the patients. Both the patients turned out to be negative for COVID-19 subsequently and discharged from hospital in stable condition. Conclusion Surgeons need to adapt to safely execute emergency surgical procedures during this period of COVID-19 pandemic. Preparedness is of paramount importance. Full precautionary measures should be taken when dealing with any suspected case.

scholarly journals An assessment of the use of patient reported outcome measurements (PROMs) in cancers of the pelvic abdominal cavity: identifying oncologic benefit and an evidence-practice gap in routine clinical practice

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Miss Charlotte L. Moss ◽  
Ajay Aggarwal ◽  
Asad Qureshi ◽  
Benjamin Taylor ◽  
Teresa Guerrero-Urbano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Abdominal Cavity ◽  
Patient Reported Outcome ◽  
Oncologic Outcomes ◽  
Review Of The Literature ◽  
Outcome Measurements ◽  
Patient Reported ◽  
Cancer Setting

Abstract Background Patient reported outcome measurements (PROMs) are emerging as an important component of patient management in the cancer setting, providing broad perspectives on patients’ quality of life and experience. The use of PROMs is, however, generally limited to the context of randomised control trials, as healthcare services are challenged to sustain high quality of care whilst facing increasing demand and financial shortfalls. We performed a systematic review of the literature to identify any oncological benefit of using PROMs and investigate the wider impact on patient experience, in cancers of the pelvic abdominal cavity specifically. Methods A systematic review of the literature was conducted using MEDLINE (Pubmed) and Ovid Gateway (Embase and Ovid) until April 2020. Studies investigating the oncological outcomes of PROMs were deemed suitable for inclusion. Results A total of 21 studies were included from 2167 screened articles. Various domains of quality of life (QoL) were identified as potential prognosticators for oncologic outcomes in cancers of the pelvic abdominal cavity, independent of other clinicopathological features of disease: 3 studies identified global QoL as a prognostic factor, 6 studies identified physical and role functioning, and 2 studies highlighted fatigue. In addition to improved outcomes, a number of included studies also reported that the use of PROMs enhanced both patient-clinician communication and patient satisfaction with care in the clinical setting. Conclusions This review highlights the necessity of routine collection of PROMs within the pelvic abdominal cancer setting to improve patient quality of life and outcomes.

scholarly journals Partial hepatectomy for treatment of multiple liver abscess in a calf: a case report

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Reiichiro Sato ◽  
Kazutaka Yamada ◽  
Taiki Yokoyama ◽  
Koki Tanimoto ◽  
Shoko Takeuchi ◽  
...  
Keyword(s):  
Case Report ◽  
Partial Hepatectomy ◽  
Liver Abscess ◽  
Bacterial Infections ◽  
Umbilical Vein ◽  
Abdominal Cavity ◽  
Left Liver Lobe ◽  
Vessel Sealing ◽  
Liver Abscesses ◽  
Sealing Device

Abstract Background Umbilical vein bacterial infections may cause liver abscesses during bacterial ascent. A single liver abscess can be surgically treated by marsupialization, but a risk of recurrence or non-healing remains. Moreover, there is no effective treatment for multiple abscesses. Case presentation A 17-day-old Holstein female calf exhibited reduced general condition, swelling and drainage of the umbilicus, and pressure sores in the area of the carpus, resulting in reluctance to stand up. The umbilicus showed pain at palpation; deep abdominal palpation indicated a swollen umbilical vein coursing from the umbilicus toward the liver. Ultrasonography confirmed a swollen umbilical vein with pus accumulation and multiple abscesses in the liver. Contrast-enhanced computed tomography (CT) examination confirmed that the swollen umbilical vein with fluid continued to the liver, and multiple unenhanced lesions, most likely abscesses, were confirmed in the liver. Partial hepatectomy was performed to remove as many abscesses as possible. For the resection, a vessel sealing device (LigaSureTM) was used to excise a part of the left liver lobe. As we could not remove all the abscesses in the liver during the operation, cefazolin sodium (5 mg/kg) was administered for 14 days after surgery. Post-operatively, blood accumulation was observed in the abdominal cavity, but no signs of peritonitis were found. The calf returned to the farm on day 38 after surgery. Follow-up information was obtained after 1 year, and complications were not reported. Conclusions To our knowledge, this is the first report of partial hepatectomy using a vessel sealing device for a calf with multiple liver abscesses. This case report suggests that the combination of partial hepatectomy and long-term administration of antibacterial drugs may restore the health of calves with multiple liver abscesses.

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