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一例阿米巴肝脓肿破裂导致心脏压塞并需行心包开窗引流术的病例报告。

A case report of ruptured amoebic liver abscess causing cardiac tamponade and requiring pericardial window.

作者信息

Francis Cliojis, Soni Swati, Gupta Anunay, Agstam Sourabh

机构信息

Department of Cardiology, VMMC and Safdarjung Hospital, New Delhi, India.

Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

出版信息

Eur Heart J Case Rep. 2020 Aug 30;4(5):1-4. doi: 10.1093/ehjcr/ytaa182. eCollection 2020 Oct.

Abstract

BACKGROUND

Amoebiasis is a prevalent infection in the tropics. Amoebic liver abscess is the most common extraintestinal manifestation. Cardiac tamponade is an uncommon complication of amoebic liver abscess that may need urgent pericardiocentesis.

CASE SUMMARY

A 25-year-old man presented with abdominal pain and fever for 1 month. Abdominal ultrasound revealed a 4.7 × 4.7 cm abscess in the left lobe of the liver. Percutaneous pigtail drainage was performed to evacuate the abscess. After 2 days, the patient developed signs of cardiac tamponade and bilateral pleural effusion, requiring urgent pericardiocentesis and chest drain insertion. Persistent posterior collection of thick abscess in pericardium needed pericardial window for complete drainage. The patient recovered completely after pericardial window. There was no evidence of chronic constrictive pericarditis after 1 year of follow-up.

DISCUSSION

A rare complication of the amoebic liver abscess was observed in this young adult who developed cardiac tamponade, requiring an urgent pericardiocentesis, and later requiring pericardial window. Management includes amoebicidal and luminicidal drugs for complete eradication of .

摘要

背景

阿米巴病是热带地区的一种常见感染。阿米巴肝脓肿是最常见的肠外表现。心脏压塞是阿米巴肝脓肿的一种罕见并发症,可能需要紧急心包穿刺术。

病例摘要

一名25岁男性出现腹痛和发热1个月。腹部超声显示肝左叶有一个4.7×4.7厘米的脓肿。进行了经皮猪尾导管引流以排出脓肿。2天后,患者出现心脏压塞和双侧胸腔积液的体征,需要紧急心包穿刺术和插入胸腔引流管。心包内持续存在浓稠脓肿的后方积液需要心包开窗以完全引流。心包开窗术后患者完全康复。随访1年后无慢性缩窄性心包炎的证据。

讨论

在这名年轻成人中观察到阿米巴肝脓肿的一种罕见并发症,即出现心脏压塞,需要紧急心包穿刺术,随后需要心包开窗。治疗包括使用杀阿米巴和杀病原体药物以彻底根除……

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e92/7780479/aa4ad4e4b563/ytaa182f1.jpg

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