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Pyogenic liver abscess as initial presentation in locally advanced right colon cancer invading the liver

Kai Qu, Chang Liu, Aasef M A Mansoor, Bo Wang, Jincai Chen, Liang Yu, Yi Lv

《医学前沿（英文）》 2011年第5卷第4期页码 434-437 doi: 10.1007/s11684-011-0157-3

摘要： Locally advanced colorectal cancer complicated with adjacent organic invasion may remain confined to the local area with minimal metastasis. In the present paper, we report on a patient with advanced right colon cancer, including liver, gallbladder, and duodenal invasion behind the scene of liver abscess. resection was performed on the patient, with right-hemicolectomy, cholecystectomy, partial duodental resection, and hepatectomy. Postoperative management was administered, including nutritional support in the early postoperative period, effective anti-infection treatment, and adjuvant chemotherapy (FOLFOX4). The patient survived for 16 months after the operation. Common clinical manifestations of colorectal cancer were digestive symptoms and changes in defecation. However, the clinical manifestation of locally advanced colon cancer was extremely complicated. Extended or multivisceral resection may offer patients a chance to survive an acute crisis and allow for treatment with adjuvant therapy.

关键词： liver abscess locally advanced colon cancer multiorganic invasion

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Early diagnosis and therapeutic choice of

Jing LI, Ying FU, Ji-Yao WANG, Chuan-Tao TU, Xi-Zhong SHEN, Lei LI, Wei JIANG

《医学前沿（英文）》 2010年第4卷第3期页码 308-316 doi: 10.1007/s11684-010-0103-9

摘要： Nowadays, pyogenic liver abscess (PLA) is still a common and severe intra-abdominal infection, and had emerged as the most common pathogenic bacteria worldwide in the past ten years. Our study aims to achieve an early pathogenic diagnosis and rational therapy modality for liver abscess (KLA) through clinical data analysis. A total of 197 inpatients in Zhongshan Hospital, Shanghai, diagnosed as having liver abscess between March 2001 and September 2009 were enrolled. Patients with monomicrobial infection were divided into two groups: patients with liver abscess (KLA group, =106) and those with non- liver abscess (NKLA group, =56). A retrospective analysis was made between these two groups on the aspects of underlying diseases, clinical characteristics, laboratory data, culture results, and imaging findings. To evaluate the effects of different medical interventions, monomicrobial KLA patients were further divided into four subgroups (percutaneous liver aspiration, aspiration plus antibiotics flushing, aspiration plus retained catheter, and aspiration plus antibiotics flushing and retained catheter), and corresponding therapeutic effects were analyzed. KLA was more likely to occur in patients with coexisting diseases such as diabetes mellitus (53.77% 25.00%, =0.001) and hepatic adipose infiltration (16.04% 5.36%, =0.029). Compared to NKLA group, clinical characteristics including abdominal pain (40.57% 57.14%, =0.044), hypodynamia (19.81% 46.43%, =0.001), and hepatomegaly (4.72% 14.29%, =0.033) were much milder, but with a higher fasting blood glucose level (7.84?±?0.36 5.76?±?0.30, =0.001) on admission in KLA group. In addition, KLA abscess often appeared singly in the right lobe of the liver with gas forming nature (32.88% 13.51%, =0.039), unsmooth rim (71.23% 40.54%, =0.002), and dynamic septum enhancement (41.10% 16.22%, =0.009). Compared to mono aspiration subgroup, additional antibiotic flushing could not further improve clinical outcomes of KLA patients ( >0.05); however, the retained catheter showed obvious advantage in reducing abscess diameter (34.38?±?3.25 mm 22.67?±?2.37 mm, =0.017). It can be concluded that the strong association with diabetes, milder clinical symptoms, and gas-forming nature in CT images makes early pathogenic diagnosis of KLA possible. Comparatively, ultrasonography-guided percutaneous liver aspiration with retained catheter may be the most rational intervention modality of KLA.

关键词： liver abscess Klebsiella pneumoniae computed tomography therapy

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Therapeutic effect of medical glue combined with the great omentum in severe tunica muscularis injury

REN Peitu, LU Baochun, RUAN Xinxian, CHEN Zhiliang, MA Yuliang, FU Hong

《医学前沿（英文）》 2008年第2卷第2期页码 143-146 doi: 10.1007/s11684-008-0027-9

摘要： Twenty-seven patients with severe colon trauma treated in the Shaoxing People’s Hospital from 1995 to 2006 were retrospectively analyzed. The patients with severe tunica muscularis injury were treated by medical glue combined with the greater omentum during operations. The initial result was encouraging. All patients were cured with no anastomotic leakage or abscess. Therefore, reasonable use of medical glue combined with the greater omentum can not only improve the curative rate but also reduces postoperative complications for patients with colon injury.

关键词： abscess initial muscularis anastomotic medical