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儿童肝脓肿:10 年单中心经验。

Liver abscess in children: a 10-year single centre experience.

机构信息

Trauma Research Center, Shiraz, Iran.

出版信息

Saudi J Gastroenterol. 2011 May-Jun;17(3):199-202. doi: 10.4103/1319-3767.80384.

Abstract

BACKGROUND/AIM: Although liver abscess is more prevalent in developing countries than in developed countries, there is scant data about the characteristics of pediatric liver abscess in our region. We aimed to analyze the characteristics of pediatric liver abscess in our region and compare these with those of developed countries.

MATERIALS AND METHODS

The clinical features, laboratory, imaging, microbiologic findings, management strategy, and final outcome were extracted from the patients' records retrospectively.

RESULTS

There were 18 cases of liver abscess including 16 pyogenic liver abscess, one amebic liver abscess and one candida liver abscess. Fever and abdominal pain were the most common clinical findings and leukocytosis was the most common laboratory finding. The most predisposing factors of liver abscess were immune deficiency, minor thalassemia. Origin of liver abscess was appendicitis in two patients, the rest were considered as cryptogenic. While one patient was treated with antibiotics alone, five cases were taken for open drainage, and 12 cases were treated with percutaneous aspiration. Percutaneous aspiration failed in two patients who were later taken for open drainage, with an overall mortality rate of 5.5%.

CONCLUSION

The overall characteristics of liver abscess in children in our society are not so different from developed countries. However, in contradiction to cases reported in developed countries, most cases of liver abscess were seen in healthy patients in our centre. Moreover, liver abscess was reported in our patients at a younger age and was more commonly seen in male children. Mortality rate was similar to that of developed countries.

摘要

背景/目的:尽管肝脓肿在发展中国家比在发达国家更为普遍,但关于本地区儿科肝脓肿的特征数据却很少。我们旨在分析本地区儿科肝脓肿的特征,并将其与发达国家进行比较。

材料与方法

回顾性地从患者病历中提取临床特征、实验室检查、影像学、微生物学发现、治疗策略和最终结果。

结果

共 18 例肝脓肿,其中 16 例为化脓性肝脓肿,1 例阿米巴性肝脓肿,1 例霉菌性肝脓肿。发热和腹痛是最常见的临床发现,白细胞增多是最常见的实验室发现。肝脓肿的最主要易感因素是免疫缺陷、轻度地中海贫血。两例患者的肝脓肿起源于阑尾炎,其余均为隐源性。1 例患者单独使用抗生素治疗,5 例患者进行了开放引流,12 例患者进行了经皮抽吸。经皮抽吸在 2 例患者中失败,随后进行了开放引流,总死亡率为 5.5%。

结论

本地区儿童肝脓肿的总体特征与发达国家并无太大不同。然而,与发达国家报道的病例不同,我们中心的大多数肝脓肿患者都是健康人群。此外,在我们的患者中,肝脓肿发病年龄更小,且更常见于男童。死亡率与发达国家相似。

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本文引用的文献

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Pediatric pyogenic liver abscess.小儿化脓性肝脓肿
Pediatr Emerg Care. 2009 Feb;25(2):107-8. doi: 10.1097/PEC.0b013e318196fa9b.
2
Percutaneous aspiration versus open drainage of liver abscess in children.儿童肝脓肿的经皮穿刺抽吸与开放引流
Pediatr Surg Int. 2007 Jan;23(1):69-74. doi: 10.1007/s00383-006-1812-7. Epub 2006 Oct 26.
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Liver abscesses in children: a single center experience in the developed world.儿童肝脓肿:发达国家的单中心经验
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Hepatic abscess in patients with chronic granulomatous disease.慢性肉芽肿病患者的肝脓肿
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Pyogenic liver abscess in children--South Indian experiences.儿童化脓性肝脓肿——南印度的经验
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10

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