Yogi Barurendra R, Basnet Bal M, Thapa Sajina, Bohara Sujan
Department of Surgery, Shree Birendra Military Hospital.
Department of Pediatrics, Kanti Children's Hospital.
Ann Med Surg (Lond). 2023 Apr 5;85(5):2034-2036. doi: 10.1097/MS9.0000000000000468. eCollection 2023 May.
Neonatal liver abscess is a rare condition with a high mortality rate. However, in a low-resource setting, high clinical vigilance and the use of readily accessible diagnostic modalities can help in early diagnosis and, along with appropriate medical management, prevent lethal complication.
We present the case of a patient who presented with one day of sudden abdominal distension and two episodes of projectile nonbilious vomiting. A solitary liver abscess was diagnosed using ultrasonography and contrast-enhanced computed tomography findings, and the patient was treated conservatively with parenteral broad-spectrum antibiotics. Following the completion of the antibiotic dose, an ultrasound of the abdomen reveals that the size of the liver abscess has decreased.
Neonatal liver abscess is a rare clinical condition that causes significant morbidity and mortality in premature and term babies. In a neonate with potential risk factors, a high index of suspicion is required to make the diagnosis. Baseline tests, as well as computed tomography with or without contrast, aid in the definitive diagnosis of a hepatic abscess. For management, a multidisciplinary approach should be considered, including correction of the predisposing factor as well as appropriate medical and/or surgical intervention.
Neonatal liver abscess is frequently overlooked due to its rarity. Thus, whenever a neonate exhibits the aforementioned clinical spectrum, it should be considered in the differential diagnosis, and a diagnostic workup and treatment should be initiated as soon as possible to avoid debilitating complications.
新生儿肝脓肿是一种罕见疾病，死亡率很高。然而，在资源匮乏地区，高度的临床警惕性以及使用易于获得的诊断手段有助于早期诊断，并且与适当的医疗管理一起，预防致命并发症。
我们报告一例患者，该患者出现一天的突发腹胀和两次喷射性非胆汁性呕吐。通过超声检查和增强计算机断层扫描结果诊断出孤立性肝脓肿，患者接受了肠外广谱抗生素的保守治疗。抗生素疗程结束后，腹部超声显示肝脓肿大小减小。
新生儿肝脓肿是一种罕见的临床疾病，在早产儿和足月儿中会导致显著的发病率和死亡率。对于有潜在危险因素的新生儿，需要高度怀疑才能做出诊断。基线检查以及有或无对比剂的计算机断层扫描有助于肝脓肿的明确诊断。对于治疗，应考虑多学科方法，包括纠正诱发因素以及适当的药物和/或手术干预。
新生儿肝脓肿因其罕见性常被忽视。因此，每当新生儿出现上述临床症状时，应在鉴别诊断中予以考虑，并应尽快启动诊断检查和治疗，以避免出现使人衰弱的并发症。
