Document Detail

Clinical and microbiological features of liver abscess after transarterial embolization for hepatocellular carcinoma.
MedLine Citation:
PMID:  9399765     Owner:  NLM     Status:  MEDLINE    
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.
C Chen; P J Chen; P M Yang; G T Huang; M Y Lai; Y M Tsang; D S Chen
Related Documents :
2710665 - Multifocal necrotizing fasciitis in varicella.
19673595 - Management of pelvic instability secondary to chronic pyogenic sacroiliitis: case report.
9259885 - Rifampicin and isoniazid in the treatment of leprous nerve abscesses.
10381225 - A 10-year retrospective study of infective endocarditis at a university hospital with s...
299895 - Gastrointestinal bleeding following head injury: a clinical study of 433 cases.
25441845 - "jumping stump" phenomenon.
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    
Department of Internal Medicine, National Taiwan University Hospital, Taipei.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Abdominal Pain / etiology
Age Factors
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
Embolization, Therapeutic / adverse effects*
Fever / etiology
Gram-Positive Bacterial Infections / microbiology,  radiography,  ultrasonography
Leukocyte Count
Liver Abscess / etiology*,  microbiology,  radiography,  ultrasonography
Liver Neoplasms / pathology,  therapy*
Middle Aged
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
gamma-Glutamyltransferase / blood
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Gases; EC; EC Aminotransferases; EC Transaminase; EC Phosphatase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Octreotide inhibition of flushing and colonic motor dysfunction in carcinoid syndrome.
Next Document:  Zinc, copper, and superoxide dismutase in hepatocellular carcinoma.