Gas-forming liver abscess in a patient with multi-organ failure: role of imaging and management

Kachare, Manohar; Desai, Nutan; Patki, Vinayak; Ricci, Joseph A.; Juan, Yu Hsiang; Saboo, Sachin S.

doi:10.1179/2295333714y.0000000025

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…The hypoechogenicity and increased thickness identified in the umbilical vein wall are consistent with the inflammatory process, and the hyperechogenicity of the lumen may be associated with the time of evolution of the process and the large amount of cellularity of the purulent content, whose presence was proven at the time of necropsy. (KACHARE et al, 2014). The fusion of umbilical arteries and allantoic duct identified at necropsy was probably due to adhesions by exudate and justifies the ultrasound finding of a single caudal structure to the umbilical ring.…”

Section: Discussionmentioning

confidence: 68%

Clinical, imaginological and pathological aspects of umbilical panvasculitis in calves: case report

Silva

Pequeno

Siqueira

et al. 2021

AVB

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The diagnosis of umbilical infections in neonates can be obtained from clinical signs, but the intracavitary involvement of structures and associated complications can be underestimated, compromising the establishment of adequate therapeutic approaches or prognosis. This case report presents the clinical, imaging, pathological and microbiological aspects of an umbilical infection in calves. Physical examination of the animal identified apathy, low body score, increased volume in the umbilical region and joints. The abdominal palpation identified firm structures in topography of the arteries and umbilical vein. Imaging examinations of the abdomen and joints were performed. Multiple, hyperechogenic focal structures have been identified in the liver, as well as cylindrical and firm structures in topography of the arteries and umbilical vein. In the joints, osteolytic changes, periosteal reactions, subchondral sclerosis and formation of osteophytes were seen. Umbilical panvasculitis triggered arthritis and an infectious process in the liver, the case being assessed as having an unfavorable prognosis and the animal being referred for euthanasia. At necropsy, multifocal abscesses were observed in the pleura, ribs, omentum, spleen and liver. There was granulomatous exudate in the urinary vesicle. The affected joints presented thickening of the joint capsule with the presence of exudate. In the microbiological analysis of liver fragments, urinary vesicle content and joint exudate, Proteus mirabilis with resistance to antimicrobials was identified. Imaging studies collaborated with the establishment of the prognosis and conduct adopted, and must, whenever possible, be included in the clinical examination. In case of death, necropsy allows a correct association of clinical signs and imaging findings.

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Section: Discussionmentioning

confidence: 68%

Clinical, imaginological and pathological aspects of umbilical panvasculitis in calves: case report

Silva

Pequeno

Siqueira

et al. 2021

AVB

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Modern role of clinical ultrasound in liver abscess and echinococcosis

Barosa

Pinto²,

Caldeira³

et al. 2016

J Med Ultrasonics

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In the Western world, liver abscesses are predominantly of pyogenic origin and can present a wide range of ultrasonographic features, from a solid mass to a cystic cavity. Amoebic abscesses are endemic in tropical areas and typically round single lesions. Echinococcal cyst is diagnosed by ultrasound (US). Serology is particularly useful when pathognomonic US features are absent. Treatment is determined based on the WHO ultrasonographic classification, and puncture, aspiration, injection, re-aspiration (PAIR) is a US-guided therapeutic option. Hepatic alveolar echinococcosis presents on US as a pseudotumoral mass frequently with calcifications that may invade the biliary tree and portal and hepatic veins.

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Septic Shock in the Course of Liver Absces Rescued with Percutaneous Drainage – A Literature Review and Case Report

Snarska¹,

Michalak²,

Masiulaniec³

et al. 2016

Polish Journal of Surgery

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This study presented a septic shock occurring with striking speed during the percutaneous drainage of a large abscess of the liver in an 18-year-old female patient after an appendectomy performed 3 months earlier using the laparoscopic method because of its phlegmonous and gangraenosus inflammation. The post-operative course was complicated by increased suppuration in places after removal of the trocars. After including the intravenous antibiotic therapy and under the USG control, the percutaneous drainage of the abscess was performed. While withdrawing the guide of the drainage catheter set, the symptoms of septic shock occurred. The pharmacological treatment was applied with continuation of the antibiotic therapy till a negative result of microbiological tests was obtained and the normalization of life parameters. The patient was not qualified for treatment in the ICU. She was discharged in a generally good condition after 24 days of hospitalization. In the case of this patient, the drain covered with the content of the abscess may have contact with the adjacent tiny blood vessels, which may have contributed to the systemic inflammatory response syndrome that was linked with fast-developing sceptic shock.

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Gas-forming liver abscess in a patient with multi-organ failure: role of imaging and management

Cited by 3 publications

References 5 publications

Clinical, imaginological and pathological aspects of umbilical panvasculitis in calves: case report

Clinical, imaginological and pathological aspects of umbilical panvasculitis in calves: case report

Modern role of clinical ultrasound in liver abscess and echinococcosis

Septic Shock in the Course of Liver Absces Rescued with Percutaneous Drainage – A Literature Review and Case Report

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