Liver cysts / abscesses скачать в хорошем качестве

Liver cysts / abscesses

This is an overview of liver cysts and abscesses. This presentation was created using Google Slides. ADDITIONAL TAGS: Disease Agent Risk factors Patient Signs / symptoms Labs / findings Diagnosis Treatment / management Pyogenic abscess Poly- microbial Recent surgery; comorbid biliary tract dz (gallstones) or diverticulitis; diabetes mellitus Usually older; M=F High fever, malaise, acutely ill-appearing; extreme RUQ pain; diaphragmatic irritation Positive blood cultures; very high bili; very high liver transaminases; high WBC Imaging (abdomen CT, ultrasound) → well defined, hypoattenuating, round lesion; +/- multiple abscesses IV antibiotics, abscess drainage; +/- catheter placement. Surgical drainage if not amenable to percutaneous aspiration Amebic abscess Entamoeba histolytica (parasite, protozoa) Travel/residence in resource limited region w contaminated food/water (spread to liver through portal vein) Usually younger; M F Can be asymptomatic; usually fever and diarrhea (bloody and/or mucoid); +/- RUQ pain might refer to right shoulder; +/- pleural effusion High WBC, alk phos, mildly elevated transaminases. Single smooth cystic subcapsular mass on imaging PCR/antigen test; amebic serology Medical: Metronidazole or tinidazole + intraluminal antibiotic (eg, paromomycin); no surgery Hydatid cyst Echino- coccus (tapeworm, helminthic) Travel/residency to endemic area, farm animals (dogs, sheep) Usually younger; M=F Usually asymptomatic for years; +/- RUQ pain; +/- HSM; +/- cough/hemoptysis Eosinophilia. Large and smooth, +/- internal septations (daugher cysts), eggshell calcification on imaging +/- lung cysts IgG E granulosus hydatid serology Surgery + albendazole. Aspiration not recommended (anaphylactic shock from cyst content spillage) but maybe required for larger cysts Simple hepatic cyst None. Pathophys: epithelial lining secrets fluid Believed to be congenital Often asymptomatic; +/- dull RUQ pain; +/- abdominal bloating, +/- early satiety - incidental on imaging, no calcifications or malignant features - Liver cysts / abscesses