Document Detail


Clinical and microbiological features of liver abscess after transarterial embolization for hepatocellular carcinoma.
MedLine Citation:
PMID:  9399765     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To present the clinical and microbiological features of liver abscess after transarterial embolization (TAE) for hepatocellular carcinoma (HCC). METHODS: We retrospectively reviewed records of 452 TAE procedures in 289 patients with HCC over a 2-yr period. RESULTS: Four men and one woman with a mean age of 68.4 yr were diagnosed with liver abscess 1-8 wk (mean 4.6 wk) after the embolization. The incidence was 1.1% (5/452). Common symptoms included fever, chills, and right upper quadrant pain. Serum aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase levels and leukocyte count were frequently elevated. All the abscesses appeared as areas of hypodensity on CT scan and hypoechogenicity on ultrasonogram. The areas contained gas in the embolized tumor, which led to the suspicion and finally the diagnosis of abscess. In contrast to predominance of gram-negative aerobes in sporadic pyogenic liver abscesses, the causative microorganism was predominantly gram positive (60%). All patients were treated with parenteral antibiotics plus percutaneous aspiration, drainage, or operation, but one patient died from the abscess. CONCLUSIONS: For patients receiving TAE for HCC, few specific clinical or radiological features could readily differentiate patients complicated with liver abscess from those without. This may delay a timely diagnosis and lead to significant morbidity. Hence, in patients with risk factors, including old age, previous biliary tract disease, large tumor size (>5 cm), and gas forming in the embolized tumor, aspiration of the suspected focal hepatic lesion should be performed as soon as possible.
Authors:
C Chen; P J Chen; P M Yang; G T Huang; M Y Lai; Y M Tsang; D S Chen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  92     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1997-12-29     Completed Date:  1997-12-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2257-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, National Taiwan University Hospital, Taipei.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / etiology
Age Factors
Aged
Aged, 80 and over
Alanine Transaminase / blood
Alkaline Phosphatase / blood
Anti-Bacterial Agents / therapeutic use
Aspartate Aminotransferases / blood
Biliary Tract Diseases / complications
Carcinoma, Hepatocellular / pathology,  therapy*
Cause of Death
Drainage
Embolization, Therapeutic / adverse effects*
Female
Fever / etiology
Gases
Gram-Positive Bacterial Infections / microbiology,  radiography,  ultrasonography
Humans
Incidence
Leukocyte Count
Liver Abscess / etiology*,  microbiology,  radiography,  ultrasonography
Liver Neoplasms / pathology,  therapy*
Male
Middle Aged
Retrospective Studies
Risk Factors
Shivering
Suction
Tomography, X-Ray Computed
gamma-Glutamyltransferase / blood
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Gases; EC 2.3.2.2/gamma-Glutamyltransferase; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase; EC 3.1.3.1/Alkaline Phosphatase

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