追踪肝脓肿的罕见病因——异物。
Tracking the foreign body, a rare cause of hepatic abscess.
作者信息
Dangoisse Carole, Laterre Pierre-François
机构信息
Department of Critical Care Medicine, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, 1200 Brussels, Belgium.
出版信息
BMC Gastroenterol. 2014 Sep 27;14:167. doi: 10.1186/1471-230X-14-167.
BACKGROUND
Foreign body ingestion complicated by perforation of the digestive tract is a well-known occurrence. Contrary to this, perforation by fishbones has most often been described in South East Asian populations, and has the unusual characteristic of often being paucisymptomatic until secondary complications occur.
CASE PRESENTATION
We report the case of a 56 year-old man of asian origin who presented with a liver abscess of unknown origin, complicated by septic shock with multiorgan failure. He was later found to have a fishbone impacted in the left lobe of the liver, which had perforated the stomach and gone by unnoticed until presentation. The fishbone was extracted through laparotomy and the abscess was drained.
CONCLUSION
This report highlights a cause of liver abscesses which is likely underreported in Northern European populations and which, although rare in occurrence, should be part of our diagnostic algorithm of "cryptogenic abscesses" since surgical removal of the foreign object as drainage warrant definitive treatment.
背景
异物摄入并发消化道穿孔是一种常见情况。与此相反，鱼骨穿孔在东南亚人群中最为常见，其不同寻常之处在于，在继发并发症出现之前，通常症状较少。
病例报告
我们报告一例56岁的亚裔男性病例，该患者出现不明原因的肝脓肿，并并发感染性休克和多器官功能衰竭。后来发现有一根鱼骨嵌顿在肝脏左叶，已穿透胃壁，直至出现症状才被发现。通过剖腹手术取出鱼骨，并引流脓肿。
结论
本报告强调了肝脓肿的一个病因，在北欧人群中可能报告不足，尽管这种情况很少见，但在我们“隐源性脓肿”的诊断流程中应予以考虑，因为手术取出异物并进行引流是明确的治疗方法。
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