The American journal of gastroenterology
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Am. J. Gastroenterol. · Nov 1983
Case ReportsLiver abscess as a complication of regional enteritis: interventional considerations.
Although intra-abdominal abscesses are relatively frequent in the setting of regional enteritis, liver abscesses are rare. Pylephlebitis, steroid administration, and biliary fistulization have been suggested as inciting factors. ⋯ The percutaneous drainage proved inadequate therapy due to significant disease outside the liver involving the bowel. A review of all cases reported to date in the literature suggests that although percutaneous drainage might prove to be a satisfactory temporizing measure, all patients will require surgical exploration for definitive therapy.
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A man with alleged Crohn's disease of the terminal ileum was started on sulfasalazine. Five weeks later he developed progressive cough, shortness of breath, and fever associated with peripheral eosinophilia and bilateral pulmonary infiltrates. After withdrawal of sulfasalazine all abnormalities returned to normal. This case supports the conviction that there is an entity of sulfasalazine-induced lung disease.
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Four patients with hepatic artery aneurysm are reported. Two patients presented with abdominal pain, initially considered a consequence of pancreatic disease. ⋯ All were successfully treated with hepatic artery ligation, which left the patient free of symptoms during long-term follow-up. Arteriography should facilitate diagnosis and artery ligation appears the best treatment.
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Am. J. Gastroenterol. · Nov 1982
Case ReportsRuptured hepatic abscess: a rare cause of spontaneous pneumoperitoneum.
A 68-yr-old woman who developed an acute abdomen with clinical and radiological evidence of pneumoperitoneum is is described. At surgery, multiple left lobe hepatic abscesses were identified. ⋯ Bacteriological studies revealed Streptococcus faecalis and gas-producing Klebsiella pneumoniae from the abscess cavities. Spontaneous pneumoperitoneum secondary to a ruptured hepatic abscess has to our knowledge never been reported.