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化脓性肝脓肿继发于异物(鱼骨)的腹腔镜治疗:一例报告。

Pyogenic Liver Abscess Secondary to Foreign Body (Fish Bone) Treated by Laparoscopy: A Case Report.

机构信息

Division of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.

Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.

出版信息

Ann Hepatol. 2018 January-February;17(1):169-173. doi: 10.5604/01.3001.0010.7550.

Abstract

Liver abscess due to perforation of the gastrointestinal tract by a foreign body is a rare and possibly fatal event. Diagnosing this pathology is complicated by the lack of specific symptoms and unfamiliarity of ingestion by the patient and low clinical suspicion of this disease. In the case of liver abscess unresponsive to aspiration and administration of antibiotics, this hypothesis must be made, despite its low incidence. This case report describes and illustrates a case of liver abscess secondary to fish bone ingestion with consequent piercing of the lesser gastric curvature, diagnosed by computed tomography and specific anamnesis. Laparoscopy was performed to extract the foreign body, without complications; the patient is currently asymptomatic and does not present any abnormal physical examination findings. We believe this represents the first case report of a successful laparoscopic treatment in South America for the removal of an ingested foreign body associated with pyogenic liver abscess.

摘要

由异物穿透胃肠道引起的肝脓肿是一种罕见且可能致命的事件。由于缺乏特定症状以及患者对摄入异物的不熟悉和对这种疾病的低临床怀疑,诊断这种病理学很复杂。在抽吸和抗生素治疗无效的情况下,如果发生肝脓肿,尽管发病率较低,仍必须提出这种假设。本病例报告描述并说明了一例继发于鱼刺摄入并随后刺穿小胃曲率的肝脓肿病例,通过计算机断层扫描和特定病史进行诊断。进行了腹腔镜检查以提取异物,无并发症;患者目前无症状,也没有任何异常的体格检查结果。我们认为这是南美洲首例成功的腹腔镜治疗用于取出与化脓性肝脓肿相关的摄入性异物的病例报告。

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