Backgrounds. Pyogenic liver abscess is a rare disease whose management has shifted toward greater use of percutaneous drainage. Surgery still plays a role in treatment, but its indications are not clear. Method. We conducted a retrospective study of pyogenic abscess cases admitted to our university hospital between 1999 and 2010 and assessed the factors potentially associated with surgical treatment versus medical treatment alone. Results. In total, 103 liver abscess patients were treated at our center. The mortality was 9%. The main symptoms were fever and abdominal pain. All of the patients had CRP > 6 g/dL. Sixty-nine patients had a unique abscess. Seventeen patients were treated with antibiotics alone and 57 with percutaneous drainage and antibiotics. Twenty-seven patients who were treated with percutaneous techniques required surgery, and 29 patients initially received it. Eventually, 43 patients underwent abscess surgery. The factors associated with failed medical treatment were gas-forming abscess (P = 0.006) and septic shock at the initial presentation (P = 0.008). Conclusion. Medical and percutaneous treatment constitute the standard management of liver abscess cases. Surgery remains necessary after failure of the initial treatment but should also be considered as an early intervention for cases presenting with gas-forming abscesses and septic shock and when treatment of the underlying cause is immediately required.

Undifferentiated carcinoma is a usually aggressive, malignant epithelial neoplasm composed of atypical cells which do not display evidence of glandular, squamous, or urothelial cell differentiation.1 Mesenteric tumors are rare and consist of a heterogeneous group of lesions. Among them undifferentiated carcinoma of the mesentery is very very rare entity. Here we present a case of undifferentiated carcinoma of the mesentery in a 51 year old male admitted to the department of surgery, Shaheed Suhrawardy Medical College Hospital (ShSMCH) with rapidly increasing huge abdominal lump, central abdominal pain and weight loss. Ultrasound of the whole abdomen and CT scan of whole abdomen reports were suggestive of retroperitoneal mass. Exploratory laparotomy was done and specimen sent for histopathology. Reports were suggestive of malignant mesothelioma whereas immunohistochemistry report revealed undifferentiated carcinoma of the mesentery. To the best of our knowledge, there was no report of undifferentiated carcinoma of the mesentery in a 51 year old male from Bangladesh or any other country, 2013;5(2):114-116]

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