ABSTRACT
A 30-year-old woman presented with subacute intestinal obstruction. Clinical evaluation and radiological studies pointed toward an enteroenteric intussusception with intestinal polyps. Exploratory laparotomy revealed a retrograde intussusception mass acting as a lead point for a second prograde jejuno-jejunal intussusception. Resection and anastomosis of the involved segment was done. Histopathology revealed the presence of hamartomas. The patient was diagnosed with Peutz-Jeghers syndrome. The rarity of such a case is highlighted, and the diagnostic challenge it poses is discussed.
Subject(s)
Intussusception/etiology , Jejunal Diseases/etiology , Peutz-Jeghers Syndrome/complications , Adult , Female , Humans , Intussusception/surgery , Jejunal Diseases/surgeryABSTRACT
Liver abscesses are a common pathology in India, but a strategy for effective treatment has not been established. Eighty-two patients with liver abscess were studied over a 4-year period. Clinical features, ultrasound findings, laboratory studies, and outcome of therapy were evaluated. Treatment options were antibiotics alone, needle aspiration, catheter drainage, or open surgical drainage; 51.2% of all abscesses were amebic, 23.2% were pyogenic, and 25.6% had unknown causes. A total of 75.6% of the abscesses were solitary, with 62.2% confined to the right lobe. Pyogenic abscesses were more likely to have anemia, leukocytosis, and deranged liver function. Amebic abscesses tended to have a larger volume. Patients undergoing catheter drainage showed a more rapid reduction in initial abscess volume, whereas resolution of the abscess cavity took longer with antibiotic therapy alone. Ultrasound-guided needle aspiration and catheter drainage are safe and effective in the management of liver abscess. Drug therapy alone may be useful only in select cases.