Rasaretnam R, Wijetilaka S E
Postgrad Med J. 1976 May;52(607):269-74. doi: 10.1136/pgmj.52.607.269.
For reasons which are not quite clear amoebic liver abscesses in the left lobe are relatively uncommon. On account of the lesser bulk of the left lobe, and the potentially greater space under the left hemidiaphragm, expansive lesions within it remain less obtrusive than corresponding lesions in the right. Sixteen such cases are analysed and five distinct modes of clinical presentation have been found. Eight of the patients presented late with perforation into either the peritoneal or pleural cavities. In seven of eight remaining cases, an abdominal mass suggestive of a left lobe lesion was present. Anaemia, leucocytosis and a raised erythrocyte sedimentation rate were usually present, and in the five cases seen in the last year a positive reaction was obtained to the indirect fluorescent antibody test. Confirmatory radiological features were present only in advanced cases.
由于某些尚不完全清楚的原因,左叶阿米巴肝脓肿相对少见。由于左叶体积较小,且左半膈下潜在空间较大,左叶内的扩张性病变比右叶相应病变的突出程度要小。本文分析了16例此类病例,发现了5种不同的临床表现模式。8例患者就诊较晚,出现脓肿穿入腹腔或胸腔。其余8例中的7例,存在提示左叶病变的腹部肿块。通常会出现贫血、白细胞增多和红细胞沉降率升高,在去年见到的5例病例中,间接荧光抗体试验呈阳性反应。仅在晚期病例中出现确诊的放射学特征。