Clinical and microbiological features of liver abscess after transarterial embolization for hepatocellular carcinoma
Journal
American Journal of Gastroenterology
Journal Volume
92
Journal Issue
12 SUPPL.
Pages
2257-2259
Date Issued
1997
Author(s)
Abstract
Objectives: To present the clinical and microbiological features of liver abscess after transarterial embolization (TAE) for hepatocellular carcinoma (HCC). Methods: We retrospectively reviewed records of 452 TAE procedures in 289 patients with HCC over a 2-yr period. Results: Four men and one woman with a mean age of 68.4 yr were diagnosed with liver abscess 1-8 wk (mean 4.6 wk) after the embolization. The incidence was 1.1% (5/452). Common symptoms included fever, chills, and right upper quadrant pain. Serum aminotransferase, alkaline phosphatase, and γ-glutamyltransferase levels and leukocyte count were frequently elevated. All the abscesses appeared as areas of hypodensity on CT scan and hypoechogenicity on ultrasonogram. The areas contained gas in the embolized tumor, which led to the suspicion and finally the diagnosis of abscess. In contrast to predominance of Gram-negative aerobes in sporadic pyogenic liver abscesses, the causative microorganism was predominantly Gram positive (60%). All patients were treated with parenteral antibiotics plus percutaneous aspiration, drainage, or operation, but one patient died from the abscess. Conclusions: For patients receiving TAE for HCC, few specific clinical or radiological features could readily differentiate patients complicated with liver abscess from those without. This may delay a timely diagnosis and lead to significant morbidity. Hence, in patients with risk factors, including old age, previous biliary tract disease, large tumor size (> 5 cm), and gas forming in the embolized tumor, aspiration of the suspected focal hepatic lesion should be performed as soon as possible. Copyright ? 1997 by Am. Coll. of Gastroenterology.
SDGs
Other Subjects
alkaline phosphatase; aminotransferase; antibiotic agent; doxorubicin; gamma glutamyltransferase; gelfoam; iodinated poppyseed oil; abdominal pain; abscess drainage; adult; aged; article; artificial embolism; aspiration; chill; computer assisted tomography; echography; female; fever; gram negative bacterium; gram positive bacterium; human; intraarterial drug administration; leukocyte count; liver abscess; liver cell carcinoma; major clinical study; male; priority journal; retrospective study; Abdominal Pain; Age Factors; Aged; Aged, 80 and over; Alanine Transaminase; Alkaline Phosphatase; Anti-Bacterial Agents; Aspartate Aminotransferases; Biliary Tract Diseases; Carcinoma, Hepatocellular; Cause of Death; Drainage; Embolization, Therapeutic; Female; Fever; gamma-Glutamyltransferase; Gases; Gram-Positive Bacterial Infections; Humans; Incidence; Leukocyte Count; Liver Abscess; Liver Neoplasms; Male; Middle Aged; Retrospective Studies; Risk Factors; Shivering; Suction; Tomography, X-Ray Computed
Type
journal article