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Endoscopic Ultrasound-Guided Hepaticogastrostomy With Lumen-Apposing Metal Stent for Management of Pyogenic Liver Abscess

机译:内镜超声引导下胃造瘘术配管腔金属支架治疗化脓性肝脓肿

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摘要

A 45-year-old man presented with abdominal pain, fever with chills, nonproductive cough, mild pleurisy, and anorexia. Computed tomography scan showed a heterogeneously enhancing mass in the left hepatic lobe with leukocytosis and elevated C-reactive protein. Interval growth of the lesion was noted on magnetic resonance imaging obtained several days after admission. Given the clinical suspicion for pyogenic liver abscess and favorable location in the left hepatic lobe, endoscopic ultrasound-guided drainage was pursued. The patient underwent endoscopic ultrasound-guided hepaticogastrostomy with a lumen-apposing metal stent. His symptoms gradually abated after procedure. Radiographic resolution of the abscess was noted 1 week after stent placement, and the stent was subsequently removed. He had no clinical or radiographic evidence of recurrence at 1-month follow-up.
机译:一位45岁的男性出现腹痛,发冷,无生产性咳嗽,轻度胸膜炎和厌食症。计算机断层扫描显示左肝叶中的异质性肿块伴有白细胞增多和C反应蛋白升高。入院后几天获得的磁共振成像记录了病灶的间隔生长。考虑到化脓性肝脓肿的临床怀疑和左肝叶的有利位置,人们寻求内镜超声引导下引流。该患者接受了带腔的金属支架内镜超声引导下胃造瘘术。手术后他的症状逐渐减轻。放置支架1周后发现脓肿的影像学分辨率,随后取出支架。他在1个月的随访中没有复发的临床或影像学证据。

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