ABSTRACT
We present the case of a liver abscess that formed secondary to foreign bodies and formed a fistula the ascending colon and was successfully treated with percutaneous abscess drainage and colonoscopic removal of foreign bodies. A 64-year-old man presented with right upper and lower quadrant pain of 2 weeks' duration. Abdominal computed tomography was performed, demonstrating a single 3.5 x 1.9-cm abscess of the liver's right lobe and eccentric thickening of the colon wall at hepatic flexure. A percutaneous hepatic drainage catheter was placed under ultrasound guidance. Colonoscopic examination revealed multiple diverticula of the ascending colon and two 1.5-cm long fish bones at the ascending colon near the hepatic flexure. One end of each fish bone had impacted the edematous colonic mucosa and was surrounded by exudate polypoid inflammatory tissue. The fish bones were extracted with forceps. The patient was feeling well and was discharged after 12 days of treatment.
Subject(s)
Colon/injuries , Colonic Diseases/etiology , Foreign Bodies/complications , Intestinal Fistula/etiology , Liver Abscess/etiology , Liver/injuries , Wounds, Penetrating/complications , Animals , Colonic Diseases/diagnosis , Colonic Diseases/surgery , Colonoscopy , Diagnosis, Differential , Drainage , Fishes , Follow-Up Studies , Foreign Bodies/diagnosis , Foreign Bodies/surgery , Humans , Intestinal Fistula/diagnosis , Intestinal Fistula/surgery , Liver Abscess/diagnosis , Liver Abscess/surgery , Male , Middle Aged , Tomography, X-Ray Computed , Wounds, Penetrating/diagnosis , Wounds, Penetrating/surgeryABSTRACT
Bacterial pericarditis has been recognized as a rare disease since the development of antibiotics. Usually, the disease is associated with underlying conditions or a seeding of infection elsewhere to the pericardium. Here we describe a case of group G streptococcal pericarditis as an initial presentation of colon cancer. A 52-yr-old man was admitted because of dyspnea. An electrocardiogram showed a diffuse ST-segment elevation and a two-dimensional echocardiogram showed a large amount of pericardial effusion. A pericardiocentesis was done and purulent fluid was drained. Group G streptococci was cultured in pericardial fluid. The patient was treated with antibiotics and pericardiostomy with saline irrigation. A colonoscopy revealed a small mass with moderately differentiated adenocarcinoma in rectosigmoid colon. He underwent a mucosectomy and was recovered without any complication.
