Liver abscess mimicking tumor: A pediatric case report

A case report of a 3-year-old boy with past medical history of intestinal partially treated amebiasis, is presented. The patient was admitted to Pediatric Unit, San Cristóbal Central Hospi- tal, Táchira, Venezuela, with abdominal pain and fever. An abdominal bloating and a 3 cm palpable hepatomegaly below the right costal margin were assessed. Abdominal ultrasound revealed a liver enlarged in the right antero-superior area. A rounded space-occupying lesion, predominantly solid, with mixed-echo patterns, was assessed using ultrasound. The preliminary diagnosis issued was of acute medical abdomen with hepatic space-occupying lesion considered amebic liver abscess or liver tumor, moderate hypochromic microcytic anemia, and malnutrition with short stature. During the case evolution, a frst computerized tomography exploration was necessary in order to exploit the capacity of this imaging tech- nique to scan an abscess as a peripheral pseudo-capsule showing rim enhancement. Nevertheless, this theoretical shape associated with abscesses on computerized tomog- raphy scans was unable to verify in this study. At this point, the mixed-echo patterns of the preliminary ultrasound study and the imprecision of the computerized tomography scan to categorize the lesion as an abscess or a tumor, do not allow establishing a defnitive diagnosis. A management based on antibiotic therapy is then proposed. The progression of the space-occupying lesion was performed using ultrasound and computerized tomography scans during the clinical evolution. The imaging controls probe a slight decrease of the liver le- sion, which is diagnosed as a liver abscess. Percutaneous transhepatic drainage was performed. An amoebic liver ab- scess in resolution was fnally diagnosed.

• Autores: Vera, María; Vera, Miguel; Bravo, Antonio
• Fecha de publicación: 2020
• Institución: Universidad Simón Bolívar
• Repositorio: Repositorio Digital USB
• Idioma: eng
• OAI Identifier: oai:bonga.unisimon.edu.co:20.500.12442/6788
• Acceso en línea: https://hdl.handle.net/20.500.12442/6788; http://www.revistaavft.com/images/revistas/2020/avft_4_2020/21_liver_abscess.pdf
• Palabra clave: Liver abscess; Liver tumor; Amebiasis; Antibiotic therapy; Ultrasound; Computerized tomography; Absceso hepático; Tumor de hígado; Amebiasis; Terapia antibiótica; Ultrasonido; Tomografía computarizada
• Rights: openAccess
• License: Attribution-NonCommercial-NoDerivatives 4.0 Internacional