Tuberculous liver abscess

Objective & Hypothesis:A twenty-three year-old male patient admitted with complaints of malaise, anorexia, weight loss during a one-year period and complaints of cough and purulent sputum during the last few months.

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Key Findings & Data:Since posteroanterior and lateral chest-X rays of the patient revealed an elevated right hemidiaphragm, thoracic and liver computed tomographic examinations were performed showing an abscess cavity in the liver.

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Conclusion & Impact:The patient is reported as an interesting case of tuberculosis presenting with a liver abscess.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Erişkin · Tüberküloz · hepatik

Abstract

A twenty-three year-old male patient admitted with complaints of malaise, anorexia, weight loss during a one-year period and complaints of cough and purulent sputum during the last few months. Since posteroanterior and lateral chest-X rays of the patient revealed an elevated right hemidiaphragm, thoracic and liver computed tomographic examinations were performed showing an abscess cavity in the liver. During bronchoscopy, right middle lobe bronchus as well as lower lobe medial segment bronchus were seen as narrowed. The cytological examination of the bronchial lavage fluid revealed an inflammatory exudate; while the pathological examination of the biopsy specimen suggested acute suppurative bronchitis. While the investigations for a pyogenic or amebic abscess were carried on, the patient was referred to the department of Thoracic Surgery due to hemoptysis. The subphrenic region was drained during surgery. A hard fluctuating mass which extends beyond the subphrenic area into the liver was resected as much as possible. The specimen taken from the subphrenic area showed a granulomatous inflammation with caseation necrosis on histopathological examination. The patient is reported as an interesting case of tuberculosis presenting with a liver abscess.

Özet

Yirmi üç yaşındaki erkek hasta bir yıldır devam eden halsizlik, iştahsızlık, kilo kaybı ve son aylarda başlayan öksürük ve pürülan balgam çıkarma şikayetleri ile başvurdu. Posteroanterior ve yan akciğer grafilerinde sağ hemidiyafragması yüksek olan hastanın toraks ve karaciğer bilgisayarlı tomografi incelemelerinde karaciğerde apse ile uyumlu görünüm saptandı. Bronkoskopisinde sağ orta lob ve alt lob medial segment bronşunun dıştan bası ile daraldığı görüldü. Alınan bronş lavajının sitolojik incelemesi iltihabi eksuda olarak, biyopsi materyalinin patolojik incelemesi ise akut süpüratif bronşit olarak yorumlandı. Amip apsesi veya nonspesifik piyojen apse yönünden araştırılmakta iken hemoptizisi olan hasta Göğüs Cerrahisi Bölümü'ne devredildi. Operasyonda subfrenik alan drene edildi. Subdiyafragmatik alanda başlayıp karaciğer içine doğru uzanan sert, ortasında fluktuasyon veren kitle olabildiğince rezeke edildi. Subfrenik mesafeden alınan materyalin histopatolojik incelemesi sonucu kazeifikasyon nekrozu içeren granülomatöz inflamasyon olarak rapor edildi. Hasta karaciğer apsesi ile kendini gösteren ilginç bir tüberküloz olgusu olarak sunuldu.

Keywords

Erişkin Tüberküloz hepatik Bronkoskopi Karaciğer apsesi Erkek Adult Tuberculosis Hepatic Bronchoscopy Liver Abscess Male

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Cite This Article

GÖKIRMAK, M., SOYSAL, Ö., BAYSAL, T., KÖKSAL, N., YILDIRIM, Z., AYDIN, A., HASANOĞLU, H. C. (2000). Tuberculous liver abscess. Toraks Dergisi, Cilt: 1 - Sayı: 3, 61–64. https://ajindex.com/articles/368192

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