Giant Liver Abscess with Atypical Clinical Presentation: Case Report.

Authors

  • Alejandro Alberto Flores-López General Surgery Resident, Clínica Hospital Mérida Issste. Calle 21 Comisaría de Susulá Mérida, Yucatán, México PC 97314
  • Adriana Guadalupe Gómez-Salazar Undergraduate Internal Physician, Clínica Hospital Mérida Issste. Calle 21 Comisaría de Susulá Mérida, Yucatán, México PC 97314
  • Ricardo Efraín Chacón-Pacho General Surgeons, Clínica Hospital Mérida Issste. Calle 21 Comisaría de Susulá Mérida, Yucatán, México PC 97314
  • Alicia Valeria Espinosa-Rosales General Surgery Resident, Clínica Hospital Mérida Issste. Calle 21 Comisaría de Susulá Mérida, Yucatán, México PC 97314
  • Luis Arturo Falcón-Cancino General Surgery Resident, Clínica Hospital Mérida Issste. Calle 21 Comisaría de Susulá Mérida, Yucatán, México PC 97314
  • Luis Alejandro Agustín-Martínez General Surgery Resident, Clínica Hospital Mérida Issste. Calle 21 Comisaría de Susulá Mérida, Yucatán, México PC 97314
  • Cristóbal Aldair Cáceres-Moreno Undergraduate Internal Physician, Clínica Hospital Mérida Issste. Calle 21 Comisaría de Susulá Mérida, Yucatán, México PC 97314
  • Alejandro Lenin Villalobos-Rodríguez Ob Gyn, Clínica Hospital Mérida Issste. Calle 21 Comisaría de Susulá Mérida, Yucatán, México PC 97314
  • Guillermo Padrón-Arredondo General Surgeons, Clínica Hospital Mérida Issste. Calle 21 Comisaría de Susulá Mérida, Yucatán, México PC 97314

DOI:

https://doi.org/10.14738/bjhmr.102.14182

Keywords:

liver abscess, amebiasis, Entamoeba histolytica, Open surgery

Abstract

Background. Amebiasis is caused by the protozoan Entamoeba histolytica. This parasite exists in 2 stages: a cyst, which is the infective form, and a trophozoite stage, which is the form that causes invasive disease. Globally, around 500 million people are infected annually. Clinical case. A 73-year-old female upon arrival at the emergency department with laboratories without alterations. Relevant ultrasound reports chronic gallbladder lithiasis not exacerbated and significant gastric distension. A liver abscess is suspected, for which an assessment is requested by the interventional radiology service for percutaneous drainage, commenting that it is not a candidate because, due to ultrasonographic characteristics in the scan before the puncture, they suspect a hydatid cyst and the puncture site is proximal to the blood vessels. It is programming exploratory laparotomy with the following findings: enlarged liver, firm adhesions to the posterior wall of the stomach and the diaphragm, a hepatic abscess is drained, obtaining 2000 mL of thick purulent material, it is marsupialized and culture is taken with a negative report to bacterial development at 48 hours. Discussion. It is a 44-year-old male with intense abdominal pain in the right upper quadrant, generalized jaundice, tachycardia, and fever; the hepatic edge is palpated 5 cm below the costal margin, positive Murphy's sign. Laboratory studies: direct hyperbilirubinemia, elevation of alkaline phosphatase and transaminases, leukocytosis, a negative viral panel for hepatitis, and positive antibodies for Entamoeba histolytica. The abdominal computed tomography showed a hypodense lesion measuring 15 by 12.1 cm in the right hepatic lobe.

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Published

2023-03-30

How to Cite

Flores-López , A. A., Gómez-Salazar, A. G. ., Chacón-Pacho , R. E. ., Espinosa-Rosales, A. V. ., Falcón-Cancino, L. A. ., Agustín-Martínez, L. A. ., Cáceres-Moreno, C. A., Villalobos-Rodríguez, A. L., & Padrón-Arredondo , G. . (2023). Giant Liver Abscess with Atypical Clinical Presentation: Case Report. British Journal of Healthcare and Medical Research, 10(2), 163–169. https://doi.org/10.14738/bjhmr.102.14182

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