Sotto Mayor Joana, Robalo Maria Margarida, Pacheco Ana Paula, Esperança Sofia
Department of Internal Medicine, Hospital de Braga, Braga, Portugal.
Hospital de Braga, Braga, Portugal.
BMJ Case Rep. 2016 May 11;2016:bcr2016214841. doi: 10.1136/bcr-2016-214841.
Pyogenic liver abscess is a rare entity, but it is fatal when untreated. With a peak incidence in the fifth decade of life, its early recognition and intervention are key to successful treatment and better prognosis of patients. In recent years, its approach has been enhanced by the use of percutaneous drainage, improved imaging techniques and a better microbiological characterisation, allowing for a more appropriate use of antibiotics. Clinical manifestations are variable and depend on the size of the abscess, the condition of the patient, associated diseases and possible complications. Among the most common symptoms that stand out are the pain in the upper quadrants of the abdomen, high fever, nausea and vomiting. The authors present the case of a patient who developed an atrial flutter as the initial presentation of a hepatic abscess that imagiologically mimicked a hepatic tumour.
化脓性肝脓肿是一种罕见疾病，但未经治疗时会致命。其发病高峰在50岁左右，早期识别和干预是患者成功治疗及获得更好预后的关键。近年来，经皮引流、改进的成像技术以及更完善的微生物特征分析等方法的应用，使得对其治疗有了改进，从而能更合理地使用抗生素。临床表现多样，取决于脓肿大小、患者状况、相关疾病及可能的并发症。其中最常见的突出症状是上腹部疼痛、高热、恶心和呕吐。作者报告了一例患者，其以心房扑动作为肝脓肿的首发表现，影像学上酷似肝肿瘤。
