Waghmare Mukta, Shah Hemanshi, Tiwari Charu, Khedkar Kiran, Gandhi Suraj
Department of Pediatric Surgery, Topiwala National Medical College & B.Y.L. Nair Charitable Hospital, Mumbai, Maharashtra, India.
Euroasian J Hepatogastroenterol. 2017 Jan-Jun;7(1):23-26. doi: 10.5005/jp-journals-10018-1206. Epub 2017 May 5.
Liver abscess is common in pediatric population in India. Children have unique set of predisposing factors and clinical features. Liver abscesses are infectious, space-occupying lesions in the liver; the two most common abscesses being pyogenic and amebic. Its severity depends on the source of the infection and the underlying condition of the patient.
A total of 34 patients less than 12 years were assessed in a retrospective study from January 2012 to 2016. Patients were assessed in terms of age of presentation, etiology, bacteriology, diagnosis, and modality of treatment.
The mean age of presentation was 6.3 years. Average volume of abscess was 164 cc. Nine patients (26.4%) underwent percutaneous needle aspiration under ultrasound guidance with wide bore needle (18 G disposable needle). Three patients required more than two sittings of aspiration. Patients with volume more than 80 cc were treated with catheter drainage. Twenty patients (58.8%) underwent ultrasound-guided percutaneous catheter drainage. Two patients required catheter drainage for large abscess and needle aspiration for the smaller abscess.
Antimicrobial therapy along with percutaneous drainage constitutes the mainstay of treatment, whereas open surgical drainage should be reserved for selected cases. Waghmare M, Shah H, Tiwari C, Khedkar K, Gandhi S. Management of Liver Abscess in Children: Our Experience. Euroasian J Hepato-Gastroenterol 2017;7(1):23-26.
肝脓肿在印度儿童群体中很常见。儿童有一系列独特的易感因素和临床特征。肝脓肿是肝脏内的感染性占位性病变;最常见的两种脓肿是化脓性和阿米巴性的。其严重程度取决于感染源和患者的基础状况。
在一项回顾性研究中,对2012年1月至2016年期间的34例12岁以下患者进行了评估。对患者的就诊年龄、病因、细菌学、诊断和治疗方式进行了评估。
就诊的平均年龄为6.3岁。脓肿平均体积为164立方厘米。9例患者(26.4%)在超声引导下使用粗针(18G一次性针)进行经皮穿刺抽吸。3例患者需要进行超过两次的抽吸。脓肿体积超过80立方厘米的患者采用导管引流治疗。20例患者(58.8%)接受了超声引导下经皮导管引流。2例患者因大脓肿需要导管引流,小脓肿需要穿刺抽吸。
抗菌治疗联合经皮引流是主要治疗方法,而开放性手术引流应仅用于特定病例。瓦格马雷M、沙阿H、蒂瓦里C、凯德卡尔K、甘地S。儿童肝脓肿的治疗:我们的经验。《欧亚肝脏胃肠病学杂志》2017年;7(1):23 - 26。