Hepatic Actinomycosis in a Patient With Retained Common Bile Duct Stent

Grossen, Alyssa; Magguilli, Michael; Thai, Theresa C.; Salem, George

doi:10.14309/crj.0000000000000219

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…Die primäre Aktinomykose der Leber ist sehr selten, mit um die 110 in der englischen Literatur beschriebenen Fällen zwischen den 1960er und 2020erJahren [4,5]. Es wird ange nommen, dass Actinomyces die Leber hämato gen oder via duodenobiliären Reflux infizieren können.…”

Section: Diskussionunclassified

Primäre hepatische Aktinomykose

Ortega¹,

Potluková²,

Ercan³

et al. 2022

Swiss Med Forum

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Section: Diskussionunclassified

Primäre hepatische Aktinomykose

Ortega¹,

Potluková²,

Ercan³

et al. 2022

Swiss Med Forum

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Section: Introductionmentioning

confidence: 99%

“…3 Biliary plastic stents are recommended to be removed or exchanged within three months of their deployment as their retention may lead to complications such as cholangitis, stent breakage, stent migration, choledocholithiasis, etc. [4][5][6][7][8] Unfortunately, retention of biliary plastic stents is a problem that is seldom reported. Even in a country such as India, where there are good number of centres performing therapeutic ERCP, available literature on this topic is meagre.…”

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confidence: 99%

Retained biliary plastic stents – lest we forget

et al. 2020

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Prolonged indwelling of endoscopically placed biliary plastic stents may lead to complications. We conducted a retrospective analysis of patients who underwent endoscopic retrograde cholangio-pancreaticography (ERCP) at our centre in 2017 and were noted to have retained biliary plastic stents ( > 3 months after an index ERCP). A total of 127 patients had previously placed biliary plastic stents, out of which 45 (35.4%) were retained. The median age of the latter was 52 years (range = 22–79 years) with 27 (60%) patients being men. The median duration of the retained stents was 144 days (range = 94–3292 days). The majority of the patients were asymptomatic. However, 9 (20%) patients had cholangitis, 2 (4.4%) had choledocholithiasis, 2 (4.4%) had cholangitic abscess and 1 (2.2%) developed septicaemia. Fortunately, all these complications could be managed medically and endoscopically. Retention of biliary plastic stents is a problem often overlooked and underestimated in clinical practice. Various measures need to be instituted to create awareness of this entity to prevent undesirable outcomes.

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A 60-Year Literature Review on Hepatic Actinomycosis

et al. 2022

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Hepatic actinomycosis (HA) is a rare infection with indolent course, atypical clinical manifestations, nonspecific laboratory and imaging findings and challenging diagnosis. We describe a case of a 35-y-old female who developed HA 2 weeks after gastrectomy. In addition, we analyzed clinical characteristics and outcome of 157 additional cases of HA identified in a 60 years’ literature review. Patients with HA were predominantly male (57%) and more than one-half were between 40 and 70 years of age. Of interest, the infection was cryptogenic in 80.8% of cases. Risk factors for HA were identified in 63.1% of the patients. Clinical presentation included fever (57.7 %), abdominal pain (52.1%), weight loss (45.1%), anorexia (27.5%), fatigue and chills (12.7% each), and malaise (12%) over a 2.35±3.5 months period. Leucocytosis, elevated alkaline phosphatase, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were the most frequent laboratory findings. Radiologic imaging revealed that the right lobe was more frequently affected (62.5%) with a single lesion found in two-thirds of cases. Diagnosis was achieved by histopathologic examination in 70.6% of cases. Cultures yielded Actinomyces in 45 instances, with A. israelii being the most frequent species. Less than one half of the patients were treated only with antibiotics, while the others received combined medical and surgical treatment. The median duration of antibiotic therapy was 135 days (range: 7-730 days). The presence of multiple lesions or solid tumor like lesions was significantly associated with medical therapy alone. The outcome was favorable in most cases (94%). Although rarely encountered, HA should be considered in patients with a chronic or subacute inflammatory process of the liver, in order to promptly diagnose and treat.

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Hepatic Actinomycosis in a Patient With Retained Common Bile Duct Stent

Cited by 4 publications

References 10 publications

Primäre hepatische Aktinomykose

Primäre hepatische Aktinomykose

Retained biliary plastic stents – lest we forget

A 60-Year Literature Review on Hepatic Actinomycosis

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