Liver abscess due to amip

Liver abscess due to amip's disease overview

liver abscess is a condition that the liver is infected with pus with small holes. The liver is an important organ with many functions such as energy reserves, protein creation and eliminating harmful substances from the body. When the liver is infected or parasitic, it may appear small pus.

liver abscess caused by amoeba is a common disease in the tropics, subtropical, hot and humid climate, poor socio -economic conditions, living habits Hau. This rate is quite high in West African, South Africa, Southeast Asia ... including Vietnam. The disease can occur in all gender, all ages, but often in the South, mainly in the age of 20 - 40. , however, if not treated promptly, progress is relatively severe, even complications can die.

The cause of the disease is caused by the disease of amoeba (Entamoeba Histolytica), common after amoeba dysentery or chronic dysentery.

Under normal conditions amoeba living in the colon that mainly in the cecum, when the body's resistance decreases and the intestinal wall is damaged, the enzyme of the amoeba secretes causes ulcers in the seal. Mac and create small abscesses in the colon wall, damage the vascular wall, amoeba into the vein capillaries into the upper macadamia vein and follow the door vein system to the liver. Because the blood flow of the portal vein is largely poured into the right liver, over 80% of the liver abscess due to amoeba is encountered in the right liver. In addition, amoeba can be livered in the liver or moving directly into the liver organization. Blood vessel lesions help amoeba by vein during the circulation or vascular to the liver. Rarely in general circulation to form lung, brain, spleen by amoeba.

Causes of Liver abscess due to amip's disease

Amip is a protoEaire of the Entamoeba family. In people there are 4 types: Entamoeba, Endolima, Pseudolima and Dientamoeba. Only E.Histolytica is also known as E. Activity is disease. The E.Minuta can not cause diseases in the colon and the cocoon that spreads the disease.

After the body is infected with amoeba, the disease causes the characteristic lesions of the colon mucosa, the disease tends to last long and chronic if not treated actively. Blood vessel lesions help amoeba by vein during the circulation of the door or vascular system to the liver, where they are often blocked by venous sinuses that cause wet necrosis to set up liver abscesses.

Symptoms of Liver abscess due to amip's disease

Typical body: The most common account accounts for about 60-70% of cases

The main manifestation is the fontam (fever, right lower ribs, enlarged liver)

  • Fever: May 39 - 400C, maybe a mild fever 37.5 - 380C. Usually fever 3-4 days before the right lower part of the right ribs and liver but can also occur simultaneously with these two symptoms. 
  • Pain in the right side of the right rib and liver area: Pain of severity of severity of throbbing, severe pain, uncomfortable pain that does not dare to move strongly. Pain down the right flank penetrates the right shoulder, when the cough increases.
  • Liver is large and painful: The liver is not much 3-4 cm below the right flank soft, smooth, imprisoned, painful. Experience the liver vibration (+)

    • In addition, there may be some other less common symptoms:

  • Gastrointestinal disorders: Liquefy or bloody mucus like dysentery, occurring simultaneously with fever before or after a few days of fever. 
  • Fatigue, thinning quickly makes the wrong diagnosis of liver cancer.
  • There may be mild edema in the back of the leg (cut this sign: due to prolonged pus, leading to lowering blood protein).
    • ascites: go hand in hand with the consequences of malnutrition, no circulation.
  • Pleural effusion: Usually due to the abscess on the surface of the liver near the diaphragm, causing inflammatory reaction caused by access, so the overflow is not much belonging to Type of secretion, easily confused with lung diseases.
  • Spleen: Very rare, spleen less l - 2cm under the left flank is easy to confuse with the door cirrhosis.

    • b. Not typical

    Clinical manifestations:

  • Can not fever: no fever or fever very little for a three days and then make the patient not notice, only feel pain in the right ribs, thin weight ... This body meets 9 , 3%.
  • Prolonged fever: Monthly fever or more continuous or interrupted, liver is not even painful or painful 5%.

    • jaundice body: accounting for 3% due to the abscess on the main biliary tract. .

  • painless but painless liver, because the abscess is deep or small abscess, this form accounts for about L, 9%.
  • The liver failure: Because the abscess is too large to destroy 50% of the liver organization, in addition to the ascites exploration of the disorder, the patient can die of liver coma .
  • can be in size of the liver: The liver is not too large due to the small abscess, but the liver is too big (too big), sometimes it will reach the pelvis. 

    • The left liver abscess: Very rare, accounting for about 3 -5% of cases, difficulty diagnosis, fragile into the pericardium causing spill of the pericardium.

  • Pleural lungs: Inflammation in the liver spreads to the pleural reaction, or due to the rupture of the abscess spread to the lungs. Clinical symptoms are mostly symptoms in the lungs (cough, chest pain, sputum) and pleural symptoms are mainly, symptoms of liver abscess are not available or overshadow. With diseases of pleural lungs. 
  • Perodated pericardial effusion: from the beginning when the liver abscess founded in the liver had complications in the pericardium, symptoms of embossed heart disease Turn, there are symptoms of liver abscess covered. This form is often misdemeanoring as pericardium.

    • The liver cancer: liver is also as big and hard as liver cancer, or also thin quickly. This form encountered 15 -16% of cases.

    complications of liver abscess due to amoeba is extremely dangerous including

  • Broken into the lungs: Patients with pus or pus, pus with chocolate color, no rot.
  • Broken into the pleura: Causes the right pleural effusion. The overflow is often much, causing sudden shortness of breath, this is a medical emergency to pleenary pleurisy to suck fluid without the patient who dies from stun or suffocating
  • Broken into the pericardium: It occurs with liver abscess in the 7 - 8 feces or the abscess in the left liver. Suddenly, patients with severe breathing, cyanosis, heart examination found the clinical signs of the pericardium. /p>
  • break into the peritoneal causing peritonitis: suddenly abdominal pain, fever increased, stiff abdomen, abdominal pain, abdominal examination, abdominal fluid, pus and pus. Timely drain the abdominal cavity if not the patient dies from infection shock.

    • People at risk for Liver abscess due to amip's disease

    Factors that can increase the risk of liver abscess include:

  • Diet does not guarantee food hygiene and safety.

    • Having liver diseases, such as: liver infection or liver failure.

    Women may be at higher risk than men. However, the higher rate is not much.

  • The age of infection is about 60 to 70 years old. Liver abscess may also be encountered in infants, related to umbilical venous and infections.

    • Prevention of Liver abscess due to amip's disease

  • Wash your hands before eating, hygiene and drink, avoiding to spread cocoon into food, water
  • Treatment of feces, absolutely do not use fresh vegetable fertilizer. When using fresh vegetables to be washed, disinfected or treated with ultraviolet rays to kill the amoeba cocoon.
  • Treatment of cocoon people with metronidazol.

    • Diagnostic measures for Liver abscess due to amip's disease

    Based on the history and use of amoeba dysentery

    Diagnosis suggested when there is a fever: fever, large liver and pain.

    The diagnosis is posed when on ultrasound or CT for abscess images. 

    Diagnostic tests include

  • Regular blood tests: white blood cells increased, blood sedimentation increased.

    • Liver ultrasound: is a non -invasive test, easy to perform, very good to detect, monitor progression, and also to guide treatment. The image on the first phase ultrasound is usually the sound mixed image, the later stage is the accompanying drum with thick shells.

  • Computerized or magnetic resonance imaging is often more sensitive and more accurate than ultrasound. There are pictures of liver abscess
  • Amoeba detection by Elisa enzyme reaction.
  • Suction abscesses with chocolate color.

    • Liver abscess due to amip's disease treatments

    Amoeba liver abscess treatment is a surgical medical treatment or combined with an ultrasonic or CT scanner tip. The results of treatment depend on many factors such as the general condition of the patient, the stage of development and diagnosis of the disease, the liver damage in the stage of inflammation, early abscess, small size (<6cm ), not yet completely turned pus, quantity, size and position of abscesses.

    Today 3 coordination measures to treat liver abscess due to amoeba are:

  • Special medicine for amoeba
  • Pus removal when it has formed
    • antibiotic combined

    Pus removal when formed by pork absorption of amoeba liver abscess with amoebaicide in the following cases:

  • Liver abscess is too large in diameter> 6cm.

    • Patients with liver abscess due to amoeba are late for over 1 month.

    Method of pus suction: Pus suction under the instructions of the abdominal scanner or ultrasound. The number of suction can be 1.2 even 3 times. The reality shows that there are cases of suction up to 2.5 liters of pus in combination with amoebaicide completely.

    Surgery combined with amoebaicide use: liver abscess surgery is increasingly narrowed, limited to the following cases:

  • When the liver abscess has been dangerous complications.
  • In patients with liver abscesses that threaten complications, but for some reason, if they do not tease pus, the abscess must have surgery.
  • Patients with amoeba liver abscess are too late (when the disease lasts more than 4 months) medical treatment with pus and amoebaicide are not effective.
  • The abscess is too big, the liver is too big to the pelvis and bulging, touching it feels like a water wrap.

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