Chronic Liver Abscess Research Articles

Resection for Chronic Hepatic Abscess due to Infected Embolization Coils After Liver Injury.

Liver injuries after blunt abdominal trauma are very common. Non-operative approaches to management are now the standard of care for many patients with up to and including grade V liver injuries. However, the long-term complications associated with coil embolization can be challenging to manage. We present the case of a 29-year-old male who presented with a chronic liver abscess which contained the coils following embolization of a grade IV liver injury and the subsequent transhepatic embolization of the pseudoaneurysm. In addition, the patient developed a fistula draining the abscess through the previously placed drain site that traversed the diaphragm. A multidisciplinary discussion was held between trauma surgery, hepatobiliary surgery, thoracic surgery, and interventional radiology to discuss the best treatment plan. The patient subsequently underwent liver resection, fistula tract resection, and diaphragm repair. This case presents a definitive management strategy for these complex patients.

Surgical correction of the chronic liver purulent-septic lesions

Purpose of the study. The purpose of the study is to improve the results of surgical treatment of patients with purulent-septic lesion of the liver substantiating the indication for resection method use.
 Material and methods. The work is based on a comparative analysis of the results of examination and treatment of 64 patients aged 10 to 81 years old, with chronic liver abscesses in the department of surgery and liver transplantation during the 1995–2016 periods.
 According to the tasks of the study patients are divided into two groups. In 30 (46,8%) patients (the study group), various types of anatomical resection of the liver with a purulent lesion were performed without its dissection during the operation; in 34 (53,2%) patients (group of comparison) they performed the disclosure, sanation, drainage of purulent cavity. The majority of patients with chronic liver abscesses treated the abscess with a puncture or drainage method under the control of ultrasound in other medical institutions of Ukraine.
 Results. The results of diagnosis and treatment of 64 patients for chronic liver abscesses from 1995 to 2016 are analyzed. In the study group, the patients performed anatomical resection of the liver, in the comparison group – standard surgical interventions – the disclosure and drainage of the abscess of the liver. The duration of antibiotic therapy after surgery in the comparison group is significantly higher than in the study group, respectively, 22 ± 3,4 and 5,75 ± 1,6 days; p < 0,001. Second-line antibacterial drugs after draining operations were used more often (p < 0,001) than after resection interventions, respectively, in 94,1 and 6,6% of cases. The duration of treatment of patients in the hospital after surgery in the study group was less than in the comparison group, according to 15,1 ± 0,7 and 27,3 ± 3,05 days; total 25,9 ± 1,4 and 45,7 ± 3,45 days (p < 0,001). After drainage operations, drainages from the abdominal cavity were removed later than after resection interventions, respectively, 17,1 ± 2,8 and 6,35 ± 1,1 days (p < 0,001), through.
 Conclusion. Resection for chronic purulentseptic lesions of the liver is the priority methods of surgical treatment. The analysis of the obtained results allows us to conclude that resection technologies contribute to the rapid normalization of physical and social rehabilitation of patients with septic liver damage.

Surgical correction of chronic purulent-septic lesions of the liver

Introduction: The aim of the study is to improve the results of surgical treatment of patients with purulent-septic lesion of the liver by substantiating the indications and using the resection method. Method: According to the objectives of the study patients are divided into two groups. In 30 (46.8%) patients (the study group), various types of anatomical resection of the liver with a purulent lesion were performed without its dissection during the operation; in 34 (53.2%) patients (group of comparison) they performed the disclosure, sanation, drainage of purulent cavity. Result: The results treatment of 64 patients with chronic liver abscesses during the period from 1995 to 2016 were analyzed. In the group under study, anatomical resection of the liver was performed in patients, in the comparison group, standard surgery was the opening and drainage of the abscess of the liver. The duration of antibiotic therapy after the operation in the comparison group is significantly (p <0.001) higher than that in the study (22 ± 3.4) and (5.75 ± 1.6) days, respectively. Antibacterial preparations of the second line after drainage operations were used reliably (p <0,001) more often than after resection interventions - respectively in 94,1 and 6,6% of observations. The duration of treatment of patients in the hospital after the operation in the study group was significantly lower than in the comparison group - respectively (15,1 ± 0,7) and (27,3 ± 3,05) days; total - (25,9 ± 1,4) and (45,7 ± 3,45) days (p <0,001). Conclusion: Resection interventions in chronic purulent-septic liver lesions are the priority methods of surgical treatment. The analysis of the obtained results allows us to conclude that resection technologies contribute to the rapid normalization of physical and social rehabilitation of patients with septic liver damage.

Comparative Analysis of ”Nonequilibrium Plasma” and Cryodestruction in Surgery of Chronic Liver Abscesses in the Experiment

Comparative Analysis of ”Nonequilibrium Plasma” and Cryodestruction in Surgery of Chronic Liver Abscesses in the Experiment

Liver resection for treatment of chronic liver abscesses

Liver resection for treatment of chronic liver abscesses

An atypical presentation of intrahepatic perforated cholecystitis: a modern indication to open cholecystectomy. Report of a case

BackgroundIntrahepatic gallbladder perforation with chronic liver abscess formation was anecdotically reported in the literature. The aim of this work is to report a case of intrahepatic gallbladder perforation and its atypical clinical presentation.Case presentationA 62-year-old male patient came to our observation; his medical history showed intermittent fever up to 39-40°C of about 2 weeks and anorexia, with an overall weight loss of about 12 Kg. Physical examination of the abdomen was negative. An ultrasound of the liver and an abdominal CT angiogram detected a disomogeneous hypoechoic-hypodense area in the 5th segment of the liver. Differential diagnosis between hepatic abscess or gallbladder cancer remained open. A surgical exploration was planned. After laparoscopic exploration, a conversion to open procedure with an atypical resection of the 5th hepatic segment was performed. Histologic examination of the specimen showed an intrahepatic chronic perforation of the gallbladder with intrahepatic abscess.ConclusionTo the best of our knowledge, 18 cases have been reported in the literature as a Niemeier type I perforation. Clinical presentation, even in its extreme rarity, is more often acute. Differential diagnosis between gallbladder cancer versus liver abscess remains controversial. Open approach is mandatory in such cases.

A Clinical Presentation of a Very Rare Infection: Parenchymal Fasciola Hepatica

Fascioliasis is primarily an infection of livestock such as cattle and sheep, caused by the flat, brown liver fluke Fasciola hepatica. Humans are accidental hosts. The diagnosis of infection depends on suspicion. Radiologic findings are specific. Usually, Computed Tomography (CT) and other imaging studies show hypodense migratory lesions of the liver. The development of a chronic liver abscess appears to be extremely rare. Here we present our case with hepatic abscess due to F. hepatica, which is a rare clinical presentation.

Hepatobiliary fascioliasis in non-endemic zones: A surprise diagnosis

Fascioliasis is a zoonotic infection caused by Fasciola hepatica. Because of population migration and international food trade, human fascioliasis is being an increasingly recognised entity in nonendemic zones. In most parts of Asia, hepatobiliary fascioliasis is sporadic. Human hepatobiliary infection by this trematode has two distinct phases: an acute hepatic phase and a chronic biliary phase. Hepatobiliary infection is mostly associated with intense peripheral eosinophilia. In addition to classically defined hepatic phase and biliary phase fascioliasis, some cases may have an overlap of these two phases. Chronic liver abscess formation is a rare presentation. We describe a surprise case of hepatobiliary fascioliasis who presented to us with liver abscess without intense peripheral eosinophilia, a rare presentation of human fascioliasis especially in non-endemic zones.

Clinical application of laparoscopic hepatectomy

Objective To investigate the indications, techniques and results of laparoscopic hepatectomy. Methods The clinical data and follow-up results of 463 patients who received laparoscopic hepatectomy at our institute were retrospectively analyzed. Results From March 1, 2007 to March 31, 2011, 463 cases of laparoscopic hepatectomy were successfully carried out. Of the 463 patients,165 were with primary liver cancer, 29 with metastatic liver cancer, 143 with hepatic hemangioma, 81with hepatolithiasis and 45 with other benign liver diseases (including hepatic angiomyolipoma, hepatocellular adenoma, focal nodular hyperplasia and chronic liver abscess). The surgical approaches included laparoscopic left lateral lobectomy (93 cases), left hepatectomy (71 cases), extended left hepatectomy (4 cases), right hepatectomy (29 cases), right posterior lobectomy (24 cases), hepatectomy of segment Ⅵ (56 cases), extended right hepatectomy (2 cases), central hepatectomy (8 cases) and hepatectomy of segments Ⅶ/Ⅷ, Ⅳa, caudate lobe and the junction of segment Ⅵ and Ⅶ (41 case).Nonanntomic and wedge resection were performed on 121 patients, and combined resection on 14 patients. The mean operation time, blood loss, length of hospital stay and incidence of postoperative complications were (244.71 ± 105. 07) minutes, (460. 26±425.81) ml, (15.51 ±4.36) days and 9.29%, respectively. And no operative death occurred. In the 194 cases with malignant liver lesions,185 cases were followed up for 2 to 50 months. The 1 year and 3 year overall and disease free survival rate were 90. 8% and 87.9% , 84.2% and 73. 7% respectively. Conclusions As a means of minimally invasive surgical approach, laparoscopic hepatectomy can be selectively adopted for the treatment of all kinds of liver diseases which located at different parts of the liver, with the advantages of smaller trauma, quick recovery and cosmetic benefits. The short-term results of laparoscopic hepatectomy is superior to and its long-term results is equal to that of open surgery. Benign liver diseases, small hepatocellular carcinoma and metastatic liver cancer are the good indications for laparoscopic hepatectomy. Key words: Laparoscopy; Hepatectomy; Liver neoplasmas; Hepatolithiasis

Use of Patients' Sera for Immunoperoxidase Demonstration of Infectious Agents in Paraffin Sections

Using patients' sera diluted from 1:10 to 1:1,000 as the primary antibodies in indirect immunoperoxidase staining, the authors visualized a variety of infectious agents in formalin-fixed, paraffin-embedded tissue sections. The target lesions included 1) pyoderma caused by Staphylococcus aureus, 2) cryptococcal infection, 3) dermal sporotrichosis, 4) colon ulcer caused by amebic dysentery, 5) cutaneous leishmaniasis, and 6) chronic liver abscess containing ova of Ascaris lumbricoides. The infectious agents were clearly identified in the respective lesions. Paraffin sections of other kinds of infectious lesions served as controls to clarify the specificity of the immunostaining. While the sera of patients with bacterial and fungal infection showed a wide range of cross-reactivity against bacteria and/or fungi, those with parasitic infection exhibited a relatively good specificity for the pathogen. Almost no immunoreactivity of endogenous human IgG in the paraffin sections was demonstrated under the conditions of this study. This approach can be used in diagnostic pathology, particularly when specific heteroantisera or monoclonal antibodies are unavailable.

Fusobacterium necrophorum infection in mice as a model for the study of liver abscess formation and induction of immunity.

A mouse model is described in which intraperitoneal injection of Fusobacterium necrophorum results in chronic liver abscesses. Viable bacterial counts from mouse lung, liver, and spleen were obtained after whole organ homogenization. From 2 h to 5 days postchallenge, liver was found to contain more bacteria than lung on a per gram basis. Bacterial counts from liver and spleen were about the same during the first 8 h; thereafter liver was found to contain more bacteria. By day 13, though bacterial counts were equivalent in the three organs, abscesses were only observed in liver. This predilection for the liver may be due to a nutritional and/or microenvironmental factor(s). Blood cultures of infected mice revealed a general lack of bacteremia. Extended immunization with formalin-killed cells was found to protect mice against F. necrophorum infection.

Abscess of the liver, chronic form: Reports of three cases

1. 1. There are reported 3 cases of chronic liver abscess ranging from five to twelve years in duration. 2. 2. None of these patients was known to have suffered from any acute or chronic diarrheal ailments. 3. 3. One patient, after several weeks of drainage, had Amoeba histolytica in the discharge from the wound. The others had only the common organisms of infection. 4. 4. Every patient had suffered from chronic ill health with periods of apparent freedom from disease, but at no time was any one in normal health. 5. 5. One patient died from blood stream infection after the abscess of the liver had healed; one patient had a secondary subdiaphragmatic abscess which healed after drainage. 6. 6. All patients had a simple drainage operation.