Thompson J E, Doty J, Wittenstein G J, DenBesten L
West J Med. 1982 Feb;136(2):103-6.
During the past five years, ten documented cases of hepatic amebic abscess have required surgical intervention at Olive View Hospital, Van Nuys, California. Three of the patients underwent laparotomy when an hepatic abscess ruptured into the peritoneal cavity, and two required surgical intervention when an abscess invaded adjacent organs. Another abscess continued to enlarge despite metronidazole therapy and still another became superinfected with bacteria. In the remaining three patients, surgical procedure would have been avoided if the correct diagnosis had been made. In fact, the preoperative diagnosis in five cases was acute appendicitis. All patients survived. The incidence of Entamoeba histolytica infestation is increasing in our community. Although most patients rapidly improve with metronidazole therapy, surgical complications do arise and diagnoses are missed. This series of cases emphasizes the need for surgeons working in Southern California to familiarize themselves with the clinical features, complications and appropriate surgical treatment of amebiasis.
在过去五年中，加利福尼亚州凡奈斯市奥利夫维尤医院有10例有记录的肝阿米巴脓肿病例需要手术干预。其中3例患者在肝脓肿破裂进入腹腔时接受了剖腹手术，2例患者在脓肿侵犯邻近器官时需要手术干预。另有1例脓肿尽管接受了甲硝唑治疗仍持续增大，还有1例发生了细菌重叠感染。在其余3例患者中，如果能做出正确诊断，本可避免手术。事实上，5例患者术前诊断为急性阑尾炎。所有患者均存活。我们社区溶组织内阿米巴感染的发生率正在上升。尽管大多数患者接受甲硝唑治疗后迅速好转，但确实会出现手术并发症且会出现漏诊。这一系列病例强调，在南加州工作的外科医生有必要熟悉阿米巴病的临床特征、并发症及适当的手术治疗方法。
