[A Thrombus in the Right Atrium Associated with Pyogenic Liver Abscess].

Q4 Medicine Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-05-01
Hiroaki Yamamoto, Masanori Takamatsu, Kohei Hamada, Kazuhisa Rikitake
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Abstract

Hepatic abscesses are divided into bacterial and amoebic types. Although the prognosis of bacterial liver abscesses has improved owing to progress in drainage techniques and antimicrobial agents, poor outcomes remain common. While there have been some reports of amoebic liver abscesses complicated by thrombosis, bacterial liver abscesses and subsequent thrombus in the right atrium are very rare. We herein report the case of an 82-year-old man. He had suffered acute obstructive suppurative cholangitis 10 months previously, and bile culture yielded Enterococcus faecalis. In the present case, a right atrial thrombus caused by a bacterial liver abscess was observed and the causative organism was thought to be Enterococcus faecalis, for which was detected in a blood culture was positive. The patient was successfully treated with hepatic abscess drainage and surgical right atrial thrombectomy under cardiopulmonary bypass with a beating heart.

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[右心房血栓与化脓性肝脓肿有关]。
肝脓肿分为细菌性和阿米巴性两种。虽然由于引流技术和抗菌药物的进步,细菌性肝脓肿的预后有所改善,但预后不佳的情况仍很常见。虽然有一些阿米巴肝脓肿并发血栓形成的报道,但细菌性肝脓肿并发右心房血栓形成的病例非常罕见。我们在此报告一例 82 岁的男性患者。他在 10 个月前曾患急性梗阻性化脓性胆管炎,胆汁培养出粪肠球菌。在本病例中,观察到由细菌性肝脓肿引起的右心房血栓,致病菌被认为是粪肠球菌,其血液培养呈阳性。患者在心脏跳动的心肺旁路下接受了肝脓肿引流术和右心房血栓切除术,治疗获得成功。
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