Herman P, Pugliese V, Salem M Z, Machado M A, Bacchella T, da Cunha J E, Machado M C, Pinotti H W
Disciplina de Cirurgia do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo.
Rev Hosp Clin Fac Med Sao Paulo. 1994 Nov-Dec;49(6):234-7.
Pyogenic hepatic abscesses are uncommon. We report our findings in 51 patients with pyogenic liver abscess treated from 1975 through 1992. Twenty-eight patients were men and twenty-three were women. The median age of patients was 46 years (range, 13 to 77 years). Fever was present in 100% of patients, abdominal pain in 58.8% and jaundice in 39.2%. Twenty eight patients (54.9%) had leukocytosis; 45% hyperbilirrubinemia and 35.3% a high serum level of alkaline phosphatase. The most common cause of abscesses was biliary tract disease (66%). Thirty-three (64.7%) were surgically treated and thirteen underwent percutaneous drainage with 90.4% and 69.2% of good results, respectively. Mortality was 9.6% in the surgical group and 0% in the percutaneously drained group. A review of literature of this condition and a discussion about the diagnosis, treatment and etiopathogenesis are presented.
化脓性肝脓肿并不常见。我们报告了1975年至1992年间接受治疗的51例化脓性肝脓肿患者的研究结果。其中28例为男性,23例为女性。患者的中位年龄为46岁(范围为13至77岁)。所有患者均有发热,58.8%的患者有腹痛,39.2%的患者有黄疸。28例患者(54.9%)有白细胞增多;45%有高胆红素血症,35.3%有血清碱性磷酸酶水平升高。脓肿最常见的病因是胆道疾病(66%)。33例(64.7%)接受了手术治疗,13例接受了经皮引流,治疗效果良好的比例分别为90.4%和69.2%。手术组的死亡率为9.6%,经皮引流组的死亡率为0%。本文还对该疾病的文献进行了综述,并对其诊断、治疗和病因发病机制进行了讨论。