A RARE CASE OF COMPLICATED LIVER ABSCESS WITH MIDDLE HEPATIC VEIN THROMBOSIS: A CASE REPORT AND REVIEW OF LITERATURE

2021 ◽  
pp. 1-2
Author(s):  
V.P.S. Punia ◽  
Praveen Raman Mishra ◽  
Shaavi Mittal ◽  
Akash Bharti ◽  
Prem Kumar ◽  
...  
Keyword(s):  
Liver Abscess ◽  
Hepatic Vein ◽  
Middle Hepatic Vein ◽  
Amoebic Liver Abscess ◽  
Hepatic Veins ◽  
Review Of Literature ◽  
Extraintestinal Manifestation ◽  
Vein Thrombosis ◽  
Histolytica Infection ◽  
Life Threatening

In developing countries Amoebic liver abscess is commonly encountered disease and it’s also the commonest extraintestinal manifestation of Entamoeba histolytica infection. Usual complication of Amoebic liver abscess arises due to collection of pus in various cavities, like in peritoneal cavity following perforation, in the pleural cavity which is known as empyema thoracis, and rarely it is complicated by life threatening conditions such as venous extension of the disease involving the hepatic veins and IVC, with only few cases reported. Here we describe a case of amoebic liver abscess extending across middle hepatic vein.

scholarly journals Bilateral adrenal gland haemorrhage: an unusual cause

2014 ◽  
Vol 2014 ◽  
Author(s):  
Durgesh Gowda ◽  
Vasant Shenoy ◽  
Usman Malabu ◽  
Donald Cameron ◽  
Kunwarjit Sangla
Keyword(s):  
Adrenal Gland ◽  
Liver Abscess ◽  
Rare Complication ◽  
Amoebic Liver Abscess ◽  
List Type ◽  
Vein Thrombosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Severe Degree ◽  
Deep Vein

Summary Our patient had drainage of a large amoebic liver abscess. This got complicated by a severe degree of hypotension, which required aggressive fluid resuscitation and hydrocortisone support. Computerised tomography (CT) of the abdomen revealed bilateral adrenal gland haemorrhage (BAH) resulting in primary adrenal gland failure, which was the cause for hypotension. Patient was on long-term warfarin for provoked deep vein thrombosis of lower limb, which was discontinued before the procedure. Thrombophilia profile indicated the presence of lupus anticoagulant factor with prolonged activated partial thromboplastin time (aPTT). Patient was discharged on lifelong warfarin. This case emphasises the need for strong clinical suspicion for diagnosing BAH, rare but life-threatening condition, and its association with amoebic liver abscess and anti-phospholipid antibody syndrome (APLS). Learning points Recognition of BAH as a rare complication of sepsis. APLS can rarely cause BAH.

scholarly journals A rare hepatic mass in an Italian resident

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Matteo Borro ◽  
Giuseppe Murdaca ◽  
Monica Greco ◽  
Simone Negrini ◽  
Maurizio Setti
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Liver Abscess ◽  
Developed Countries ◽  
Abscess Cavity ◽  
Amoebic Liver Abscess ◽  
X Rays ◽  
Left Liver Lobe ◽  
Vein Thrombosis ◽  
Left Portal Vein

Abstract Background Amebiasis is a rare condition in developed countries but epidemiologically growing. Clinical manifestation may range from asymptomatic to invasive disease, amoebic liver abscess being the most common manifestation. We report a peculiar case of left hepatic amoebic liver abscess in a patient without a well-known source of infection and presenting with left portal vein thrombosis. Case presentation Patient, working as longshoreman, presented with complaints of remittent-intermittent fever lasting from 2 weeks. Physical examination was normal. Blood tests showed mild anemia, neutrophilic leukocytosis and elevated inflammation markers. Chest x-rays was normal. Abdominal ultrasound showed multiple hypoechoic liver masses. CT-scan of abdomen showed enlarged left liver lobe due to the presence of large abscess cavity along with thrombosis of left portal vein. The indirect hemagglutination test for the detection of antibodies to Entamoeba histolytica (Eh) was positive. Ultrasound-guided percutaneous drainage revealed “anchovy sauce” pus. Metronidazole and a follow up imaging at 3 months showed resolution of abscess cavity. Conclusion This case shows that amoebic liver abscess is possible even in first world country patients without travel history. Left sided abscess and portal vein thrombosis are rare and hence reported.

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 Reconstruction of the middle hepatic vein using a vein graft from the resected portion of the liver

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
ShiWei Yang ◽  
DongDong Han ◽  
Liang Wang ◽  
Lei Gong ◽  
CanHong Xiang
Keyword(s):  
Portal Vein ◽  
Hepatic Vein ◽  
Intrahepatic Cholangiocarcinoma ◽  
Vein Graft ◽  
Critical Role ◽  
Liver Volume ◽  
Middle Hepatic Vein ◽  
Postoperative Liver Failure ◽  
Hepatic Veins ◽  
Left Hepatectomy

Abstract Background The middle hepatic veins are often infiltrated by intrahepatic cholangiocarcinoma. Reconstruction of the hepatic vein plays a critical role in preserving more of the residual liver volume and reducing the risk of postoperative liver failure in extreme hepatectomy. We here report a novel way to reconstruct middle hepatic vein by using vessel grafts from wasted liver. Case presentation Case 1: A 64-year-old man was diagnosed with intrahepatic cholangiocarcinoma. The bifurcation and left branch of the portal vein were stenosed, and the root of the middle hepatic vein was infiltrated by the tumor. An extended left hepatectomy was performed, the portal vein was resected and reconstructed, and the middle hepatic vein was reconstructed by anastomosing the proximal left hepatic vein to the distal middle hepatic vein. Case 2: A 69-year-old woman was diagnosed with intrahepatic cholangiocarcinoma. The tumor was located in the left lobe of the liver and the left and middle hepatic veins were infiltrated by the tumor. An extended left hepatectomy was performed, and the left portal vein was used as a vein graft to reconstruct the middle hepatic vein. Both of the two patients’ postoperative ultrasound showed vessel graft patency. Conclusion Using a vein graft from the resected portion of the liver to reconstruct the middle hepatic vein was a useful technique and showed good result.

scholarly journals Hepatic vein variations in 500 patients: surgical and radiological significance

2019 ◽  
Vol 92 (1102) ◽  
pp. 20190487
Author(s):  
Binit Sureka ◽  
Neelmani Sharma ◽  
Pushpinder Singh Khera ◽  
Pawan Kumar Garg ◽  
Taruna Yadav
Keyword(s):  
Hepatic Vein ◽  
Inferior Vena ◽  
Multidetector Ct ◽  
Vena Cava ◽  
Middle Hepatic Vein ◽  
Hepatic Veins ◽  
Common Trunk ◽  
Biliary Anatomy ◽  
Iatrogenic Complications ◽  
Anatomy Knowledge

Objectives: The purpose of the study was to assess the incidence of hepatic vein variations on multidetector CT (MDCT) for abdominal examinations. Methods: A retrospective analysis of 534 MDCT scans was performed in patients sent for various abdominal pathologies between January 2017 and April 2019. After excluding 34 patients, finally total of 500 patients (N = 500) were included in the study. For simplification, we classified the hepatic vein variations as classified by Soyer et al, Fang et al and Cheng et al. Results: Single right hepatic vein was seen in 458 (91.6%) out of 500 patients in our study. Two right hepatic veins were seen in 36 patients out of which 27 had common trunk and nine had independent drainage into the inferior vena cava (IVC). Common trunk of middle hepatic vein (MHV) and left hepatic vein (LHV) was seen in 405 (81%) and independent drainage of MHV and LHV into the IVC was seen in 95 (19%) of patients in our study. Amongst the segmental hepatic vein variations, most common drainage of segment IV vein was into LHV (333,66.6%) followed by MHV (148,29.6%) and IVC (19,3.8%). Conclusion: Hepatic vein variations are commonly seen similar to variations in hepatic artery, portal vein and biliary anatomy. Knowledge of these variations is extremely important for transplant surgeons and intervention radiologists. Advances in knowledge: Awareness of the hepatic vein variations is essential for intervention radiologists and surgeons to reduce iatrogenic complications.

Portal and hepatic vein thrombosis in liver abscess: CT findings

2007 ◽  
Vol 61 (3) ◽  
pp. 513-519 ◽  
Author(s):  
Mohammed Aejaz Syed ◽  
Tae Kyoung Kim ◽  
Hyun-Jung Jang
Keyword(s):  
Liver Abscess ◽  
Hepatic Vein ◽  
Vein Thrombosis ◽  
Hepatic Vein Thrombosis ◽  
Ct Findings

scholarly journals How-I-do-it: laparoscopic left medial sectionectomy utilizing a cranial approach to the middle hepatic vein and Laennec’s capsule

2021 ◽  
Author(s):  
Shunya Hanzawa ◽  
Kazuteru Monden ◽  
Masayoshi Hioki ◽  
Hiroshi Sadamori ◽  
Satoshi Ohno ◽  
...  
Keyword(s):  
Hepatic Vein ◽  
Liver Parenchyma ◽  
Middle Hepatic Vein ◽  
Hepatic Veins ◽  
Parenchymal Transection ◽  
Demarcation Line ◽  
Histopathological Findings ◽  
Glissonean Approach ◽  
Grade Ii ◽  
Cranial Approach

Abstract Background Laparoscopic anatomic liver resection is technically demanding, given the need to safely isolate the Glissonean pedicles and expose the hepatic veins (HVs) on the liver parenchyma cut surface. Laennec’s capsule is observed around the Glissonean pedicles and root of the HVs. However, its existence, particularly on the peripheral side of the HVs, remains controversial. Herein, we describe Laennec’s capsule-related histopathological findings around the HVs and a safe laparoscopic left medial sectionectomy utilizing Laennec’s capsule. Methods The extrahepatic Glissonean approach was performed by connecting Gates II and III, in accordance with Sugioka’s Gate theory. Liver parenchymal transection commenced along the demarcation line, which is between the medial and lateral sections, and the G4 was dissected during transection. Subsequently, via the outer-Laennec approach, the middle hepatic vein (MHV) was exposed from the root side in cranial view, while Laennec’s capsule was preserved. Parenchymal transection was completed while connecting the MHV with the demarcation line. We obtained the membrane surrounding the HVs and performed histopathological examinations. Results Six patients underwent laparoscopic left medial sectionectomy from February 2012 to November 2020. There were no cases involving complications (Clavien–Dindo classification; grade II or higher), open-surgery conversion, transfusion, or surgery-related death. The histopathological findings showed Laennec’s capsule surrounding both the trunk of the major HVs and the peripheral side of the HVs. Conclusions A cranial approach to the major HVs utilizing Laennec’s capsule is a feasible and advantageous procedure for laparoscopic left medial sectionectomy. We propose that Laennec’s capsule surrounds the entire length of the HVs.

scholarly journals Characteristics of gas-forming pyogenic liver abscess caused by Klebsiella pneumoniae and Clostridi perfringens

2019 ◽  
Author(s):  
Zheng-Yang Chen ◽  
Nan Jiang ◽  
Song Guo ◽  
Bin-Bin Li ◽  
Jia-Qi Yang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Review Of Literature ◽  
Manual Search ◽  
Life Threatening ◽  
Low Incidence ◽  
Background Gas ◽  
Prevalence Of Diabetes Mellitus

Abstract Background: Gas-forming pyogenic liver abscess is a life-threatening disease with poor prognosis commonly caused by 2 bacteria, Klebsiella pneumoniae and Clostridium perfringens . Due to its low incidence and associated high mortality rate, it is important to study the biological characteristics of the disease. The aim of this study was to conduct a worldwide review of literature on gas-forming pyogenic liver abscess caused by K. pneumoniae and C. perfringens . Methods: We searched PubMed and Web of Science databases from January 2009 to March 2019, with published in English. All relevant articles were accessed in full text. The manual search included references of retrieved articles. Finally, 35 publications were selected for review. Results: The results showed that more cases of gas-forming pyogenic liver abscess in Asia were caused by K. pneumoniae than by C. perfringens (P=0.011). The prevalence of diabetes mellitus in patients with gas-forming pyogenic liver abscess caused by K. pneumoniae was higher than caused by C. perfringens (P=0.032). The survival rate of patients with gas-forming pyogenic liver abscess caused by K. pneumoniae who received surgical debridement or drainage was higher than caused by C. perfringens (P=0.002). Conclusions: The prevalence of diabetes mellitus was higher in patients with gas-forming pyogenic liver abscess caused by K. pneumoniae than in patients caused by C. perfringens .

scholarly journals Giant Amoebic Liver Abscess: A Rare Diagnosis in a Rural Setting of Sub-Saharan Africa

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Cyril Jabea Ekabe ◽  
Jules Kehbila ◽  
Njinju Asaba Clinton
Keyword(s):  
Entamoeba Histolytica ◽  
Liver Abscess ◽  
Clinical Evaluation ◽  
Amoebic Liver Abscess ◽  
Resource Limited Settings ◽  
Diagnosis And Management ◽  
Nonsurgical Management ◽  
Resource Limited ◽  
Histolytica Infection ◽  
Basic Investigation

Background. Extraintestinal amoebiasis is an uncommon complication of Entamoeba histolytica infection, occurring in about 5-10% of patient. Prompt diagnosis and management is essential to prevent complications. However, diagnosis and management in resource-limited settings is very challenging owing to limited diagnostic tools and nonspecific clinical symptoms. Therefore, our case report underscores the role of incisive clinical evaluation, basic investigation, and nonsurgical management of giant amoebic abscess in resource-limited settings. Case Presentation. A 13-year-old female Cameroonian presented with subacute onset of upper abdominal pain, high fever, and chest pain for one week. Before presentation, she had been on treatment at a local traditional practitioner during which her symptoms worsen. After clinical evaluation and basic investigation, she was diagnosed with a giant amoebic liver abscess. She was resuscitated and placed on nonsurgical management. Follow-up after 1 month was significant for complete recovery. Conclusion. Amoebic liver abscess is a rare complication of Entamoeba histolytica infection with devastating complications. The diagnosis of this disease requires high index of suspicion in resource-limited settings. Good clinical evaluation and timely nonsurgical therapy can provide recovery to some patients.

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