Fulminant infection with emphysematous changes in the biliary tract and air-filled liver abscesses

Zárraga, Fernando López; Aisa, Pilar; Ormijana, Julio Saenz de; Orive, M. Diez; Añorbe, Enrique; Aguirre, Xabier; Paraíso, Marie Fidela R.; Bravo, Maximiliano

doi:10.1007/s00261-005-0346-0

Cited by 9 publications

(4 citation statements)

References 12 publications

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“…Many previous cases and our case revealed that diabetes mellitus seemed to be a major risk factor for EH. [1,3,4,8,10,11] Gas collection in the lesion mainly comes from the mixed acid fermentation of glucose, including nitrogen, hydrogen, carbon dioxide, and oxygen. [12] Patients with diabetes have elevated blood glucose levels, and associated microangiopathy impairs the transportation of gas.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous hepatitis with successful treatments: A rare case report

2023

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Rationale: Emphysematous hepatitis (EH) is a rare and fulminant gas-forming liver infection. Only 3 patients were successfully treated. Diabetes mellitus and a history of digestive system cancer may predispose individuals to EH. Computed tomography (CT) findings support the diagnosis of EH and monitor progress. Patient concerns: A 48-year-old man with diabetes presented with nausea, vomiting (gastric contents) and diarrhea. Laboratory test results revealed elevated levels of inflammatory indicators and abnormal liver function. CT showed a large-scale air collection with some remaining parenchymal debris in the left lobe of the liver. Remarkably, no fluid was observed inside the lesion. Diagnose: The abdominal CT features and laboratory examination results rationalized the diagnosis of EH. Interventions and outcomes: The patient finally recovered from this severe disease through a series of effective treatments, including strict glucose control, sensitive antibiotic therapy, and subsequent percutaneous drainage. Lessons: EH generally deteriorates rapidly and eventually leads to death. This case will raise awareness of the rare and severe disease, strengthen diagnostic capacities, and provide advice to treat it.

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Section: Discussionmentioning

confidence: 99%

Emphysematous hepatitis with successful treatments: A rare case report

2023

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“…The histologic feature of emphysematous hepatitis was briefly described in a postmortem liver specimen obtained by autopsy [ 4 ]. The authors described clearly defined empty spaces covered by a patch of leukocytes without other associated changes.…”

Section: Resultsmentioning

confidence: 99%

“…Key information about the articles was extracted into a predefined datasheet: study characteristics include author, year of publication, patient characteristics (age and comorbidities), laboratory values (PCT levels, WBC levels, CRP levels, AST/ALT, bilirubin), method of diagnosis and imaging results, microbiological documentation (blood culture and/or culture from a liver sample), patient’s management and outcome. We identified 14 cases in the literature ( Table 1 ) [ 1 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”

Section: Methodsmentioning

confidence: 99%

Diagnostic and Management of Emphysematous Hepatitis with Emphasis on Biopathology

Porez,

Kallel,

Dobian

et al. 2023

Microorganisms

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Emphysematous hepatitis is a rare infectious disease, which corresponds to the presence of gas in the liver, without collection and after exclusion of vascular origin. This entity belongs to the group of emphysematous infections, whose physiopathology seems to be linked to the presence of unbalanced diabetes and to bacterial fermentation, leading to the production of gas within the liver parenchyma. Very few cases of emphysematous hepatitis have been described in the literature, and most of them had a rapidly fatal course. In this manuscript, we report the case of a 59-year-old man with emphysematous hepatitis due to wild-type Klebsiella pneumoniae that was successfully managed by surgery, and we perform a review of the literature to describe the clinical and biopathological aspects of this rare hepatic disease. Our manuscript underlines the need to perform biological and histopathological sampling to better understand the pathophysiology of this rare entity. The causes and mechanisms of emphysematous hepatitis, which seem to be multiple, lead us to believe that it is a syndrome rather than a simple infectious disease.

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“…There are currently no treatment guidelines for this fulminant condition as adequate surgical debridement is generally unobtainable and attempts at percutaneous drainage and antibiotics have not been reported to be effective. 23,24 Emphysematous pancreatitis is a rare and life-threatening condition associated with acute pancreatitis. Plain radiography typically shows nonspecific findings, such as scattered gas in the mid abdomen.…”

Section: Intraparenchymal Airmentioning

confidence: 99%

Imaging of Abnormal Air in the Abdomen and Pelvis

Sharma

McDougal

Pandey

et al. 2019

Journal of Gastrointestinal and Abdominal Radiology

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The presence of abnormal air collection on an imaging study is quite often the reason as well as the solution to a diagnostic dilemma. The purpose of this review article is to develop an understanding of anatomical localization and determine etiology of abnormal air collections in the abdomen and pelvis. Abnormal air collections are commonly encountered on imaging studies on a daily basis, and this article will help familiarize the interpreting radiologist with the pathophysiology of these collections and help solve various diagnostic challenges and avoid potential pitfalls.

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Fulminant infection with emphysematous changes in the biliary tract and air-filled liver abscesses

Cited by 9 publications

References 12 publications

Emphysematous hepatitis with successful treatments: A rare case report

Emphysematous hepatitis with successful treatments: A rare case report

Diagnostic and Management of Emphysematous Hepatitis with Emphasis on Biopathology

Imaging of Abnormal Air in the Abdomen and Pelvis

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