Takahashi Norifumi, Arakawa Kazuhisa, Sunose Yutaka, Totsuka Osamu, Toya Hiroyuki, Takeyoshi Izumi
Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine.
Nihon Shokakibyo Gakkai Zasshi. 2011 Aug;108(8):1413-9.
A 26-year-old man was admitted to our hospital because of a high-grade fever and abdominal pain. A blood test showed marked inflammation. Enhanced computed tomography (CT) showed an 8.0×6.0cm cystic lesion in the left hepatic lobe. Esophagogastroduodenoscopy showed a huge egg-yolk-like mass in the gastric submucosa in the lesser curvature of the gastric body from the gastric angle. There were 3 ulcers on the mass, out of which milky pus flowed. Trophozoites of Entamoeba histolytica were detected from cultures of the liver abscess and a biopsy of the gastric ulcers. The amoebic dysentery antibody titer was increased 1600 times. An amoebic liver abscess complicated by a gastric fistula was diagnosed. As therapy, oral metronidazole was administered for 2 weeks without percutaneous drainage. The systemic inflammatory findings improved immediately and the abscess decreased markedly in size.
一名26岁男性因高热和腹痛入院。血液检查显示有明显炎症。增强计算机断层扫描（CT）显示左肝叶有一个8.0×6.0cm的囊性病变。食管胃十二指肠镜检查显示在胃体小弯侧胃角处的胃黏膜下层有一个巨大的蛋黄样肿物。肿物上有3处溃疡，有乳白色脓液流出。从肝脓肿培养物和胃溃疡活检中检测到溶组织内阿米巴滋养体。阿米巴痢疾抗体滴度升高了1600倍。诊断为阿米巴肝脓肿合并胃瘘。作为治疗，口服甲硝唑2周，未进行经皮引流。全身炎症表现立即改善，脓肿大小明显减小。
