Hodkinson J, Couper-Smith J, Kew M C
Department of Medicine, Witwatersrand University Medical School, Johannesburg, South Africa.
Am J Gastroenterol. 1988 Jul;83(7):786-8.
We describe a 50-yr-old black laborer who presented with right lower chest pain, weight loss, and pedal edema. Ultrasonography and computed tomograms showed a large abscess cavity in the right lobe of the liver which extended very close to the inferior vena cava. The lumen of the adjacent inferior vena cava was partially occluded by thrombus, which could be traced up into the cavity of the right atrium. The hepatic veins were normally patent. Sterile blood-stained pus was aspirated from the abscess. Antibodies against Entamoeba histolytica were present in high titer in the patient's serum. Although propagation of hepatocellular carcinoma into the inferior vena cava and even up into the right atrium is well recognized, inferior vena caval thrombosis extending up into the right atrium has not hitherto been reported as a complication of amebic hepatic abscess.
我们描述了一名50岁的黑人劳工，他出现右下胸痛、体重减轻和足部水肿。超声检查和计算机断层扫描显示肝脏右叶有一个大脓肿腔，该脓肿腔非常靠近下腔静脉。相邻下腔静脉的管腔被血栓部分阻塞，血栓可向上追踪至右心房腔。肝静脉通常通畅。从脓肿中抽出无菌血性脓液。患者血清中抗溶组织内阿米巴抗体呈高滴度。虽然肝细胞癌扩散至下腔静脉甚至向上至右心房已广为人知，但下腔静脉血栓形成向上延伸至右心房作为阿米巴肝脓肿的并发症迄今尚未见报道。
