RESUMO
Introduction: Liver (hepar) is a largest metabolic center in the body. It is said that the liver is the busiest port in the lake of life. Etiology of the liver abscess has changed to pyogenic abscess (PA). PA of liver remains a major diagnostic and therapeutic challenge despite advances in diagnostic technology and new strategies for treatment. Materials and Methods: Ninety-six patients aged between 25 and 65 years visiting MediCiti Hospital (MediCiti Institute of Medical Sciences), Ghanpur, Medchal – 501401, Telangana, were selected for study. Results: The clinical manifestation was as follows: 72 (75%) had fever, 72 (75%) had abdominal pain, 70 (72.9%) had nausea and vomiting, 48 (50%) had night sweats, 42 (43.7%) had weight loss, 9 (9.37%) had jaundice, 29 (302%) had diarrhea, and 38 (39.5%) had chest symptoms (cough, chest pain, and shortness of breath). Hematological and biological study had 54 (56.2%) 45–46 (u/I) alanine aminotransferase (ALT), 42 (43.7%) had 47–48 ALT, and 38 (39.5%) had 40–41 (u/I) ALT; 38 (39.5%) had 40–41 aspirate aminotransferase (AST) and 58 (60.4%) had 42–43 (u/I) AST; 62 (64.5%) had 470–471 alkaline phosphatase (ALP) (u/I) and 34 (35.4%) had 472–473 ALP (U/I); 52 (54.1%) had 11–12 serum bilirubin (Mm/I) and 44 (45.8%) had 13–14 serum bilirubin (Mm/I); 62 (64.5%) had 11–11.5 hemoglobin (Hb)% (gm/I), 62 (64.5%) had 11.6–11.7 Hb% (gm/I), and 34 (35.4%) had 11.6–11.7 Hb% (gm/I); 51 (53.%) had 17.2–17.3 white blood count (WBC) (× 109/I) and 45 (46.8%) had 17.4–17.5 WBC (× 109/I); and 53 (55.2%) had 14.45–14.46 neutrophils and 43 (44.7%) had neutrophils 14.47–14.48 (109/I). The isolated bacteria were as follows: 32 (33.3%) were Gram negative, 17 (17.7%) were anaerobic Bacilli, and 47 (48.9%) were streptococci. Conclusion: The initial diagnostic investigation, antibiotics as first-line treatment followed by antibiotic with PNA/PDA, and ultimately, surgery was effective treatment. Such types of approach will have better prognosis except in patients with malignant disease.
RESUMO
Introduction: Cholecystitis is a potentially life-threatening condition which affects >20 million globally every year. Gall bladder (GB) stones are the major contributor to acute cholecystitis (AC). Materials and Methods: Eighty-six patients (32 males and 54 females) aged between 25 and 60 years who were regularly visiting MediCiti Institute of Medical Science Hospital having symptoms of cholelithiasis were selected for study. Results: The clinical manifestation was 100% tenderness in right hypochondrium, 28 (32.5%) had fever, 6 (6.97%) had jaundice, 23 (26.7%) had vomiting, and 29 (33.7%) had leukocytosis. The mode of presentation was as follows: 14 (16.2%) had emergency and 72 (83.7%) has elective presentation, and types of pathology were as follows: 75 (87.2%) had calculus cholecystitis and 11 (12.7%) had idiopathic. The organism cultured post-surgically were as follows: 29 (33.7%) had Escherichia coli, 14 (16.2%) had Staphylococcus aureus, 6 (6.97%) had Salmonella, 13 (15.1%) had no organism, and 24 (27.9%) were not done culture due to early healing. This pragmatic approach to the patients with different clinical manifestation with different organism culture study at different age in both sexes will be quite useful to surgeons and physicians to treat efficiently cholecystitis to prevent morbidity and mortality. Conclusion: Clinician at various levels needs to have good understanding of varied clinical presentations of AC, silent (chronic) cholecystitis, and different management options, their pros and cons to be able treat the conditions effectively