Abello Vaamonde Jorge A, White Elizabeth Gil, López Alfredo Muñoz, Lorenzo Silva José M
Thoracic Surgery Division, Hospital Español de Mexico, Ciudad de Mexico, Mexico.
J Surg Case Rep. 2022 Jul 22;2022(7):rjac334. doi: 10.1093/jscr/rjac334. eCollection 2022 Jul.
Liver abscesses are a common complication in patients with amebiasis. Rarely, these will rupture across the diaphragm causing life-threatening empyemas. Evidence justifies performing surgical debridement or decortication for their treatment, given the better overall performance in comparison to open surgeries. However, no current guideline specifies which is the best approach. This report presents the case of a 39-year-old male with clinical, radiographical and microbiological evidence of an amebic empyema secondary to an amebic liver abscess, who received treatment by video-assisted thoracoscopy. The case description highlights the surgical technique, findings and operative outcomes that could be taken into consideration by other physicians to timely manage similar cases. The latter is especially relevant in underdeveloped and developing countries, where the burden of amebiasis appears to be greater. To the best of the authors' knowledge, this is the first description of a transdiaphragmatic amebic infection treated in a minimally invasive fashion.
肝脓肿是阿米巴病患者的常见并发症。这些脓肿很少会穿过膈肌破裂,导致危及生命的脓胸。鉴于与开放手术相比总体表现更好,有证据支持对其进行手术清创或剥脱术治疗。然而,目前尚无指南明确哪种方法最佳。本报告介绍了一名39岁男性病例,该患者有阿米巴肝脓肿继发阿米巴脓胸的临床、影像学和微生物学证据,接受了电视辅助胸腔镜治疗。病例描述突出了手术技术、发现和手术结果,其他医生在及时处理类似病例时可予以考虑。这在欠发达国家和发展中国家尤为重要,因为这些国家的阿米巴病负担似乎更大。据作者所知,这是首次对以微创方式治疗的经膈肌阿米巴感染进行描述。