1.5 EXTRA-INTESTINAL AMEBIASIS
Amebic liver abscess is the most common extraintestinal
manifestation of amebiasis.
Males are more commonly affected and the greatest incidence
is in the third, fourth and fifth decades
LIVER
Invasion of the wall of the colon results in involvement of
mesenteric venules and the amebae enter into the protal
circulation.
Portal circulation favours lodging of amebae in the right lobe.
Most trophozoites are eradicated but when circumstances are
favourable tiny colonies arise and coalesce to form an abscess.
- Within the abscess trophozoitis accumulate at the periphery,
while the central portion contains variable amounts of blood,
necrotic hepatic cellular debris, and leucocytes.
- The lesion most often starts, in the portal triad, and extends
peripherally towards the capsule of the liver.
In the early stages, an area of necrotic tissue, which may contain leucocytes, connective tissue cells and occasional ameba, is surrounded by a zone of hyperemia.
- Later, a more well defined capsule develops in which ameba can
be found.
- Secondary,bacterial infection is reported in less than 5% of
cases. Microscopically THREE zones are recognised.
* A necrotic center
* A middle zone with distruction of parenchyma but with some
persistence of stroma
* A relatively normal liver tissue in which ameba can be
demonstrated
Treatment is with amebacidal drugs and surgery for drainage.
Any questions be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for your access and review.
Visitors that follow the site may post contributions to the site.
To introduce consumer/provider convergence visit http://bit.ly/cPTh6f
http://www.otmanage.blogspot.com/
Click on image to see detail.
Amebic liver abscess is the most common extraintestinal
manifestation of amebiasis.
Males are more commonly affected and the greatest incidence
is in the third, fourth and fifth decades
LIVER
Invasion of the wall of the colon results in involvement of
mesenteric venules and the amebae enter into the protal
circulation.
Portal circulation favours lodging of amebae in the right lobe.
Most trophozoites are eradicated but when circumstances are
favourable tiny colonies arise and coalesce to form an abscess.
- Within the abscess trophozoitis accumulate at the periphery,
while the central portion contains variable amounts of blood,
necrotic hepatic cellular debris, and leucocytes.
- The lesion most often starts, in the portal triad, and extends
peripherally towards the capsule of the liver.
In the early stages, an area of necrotic tissue, which may contain leucocytes, connective tissue cells and occasional ameba, is surrounded by a zone of hyperemia.
- Later, a more well defined capsule develops in which ameba can
be found.
- Secondary,bacterial infection is reported in less than 5% of
cases. Microscopically THREE zones are recognised.
* A necrotic center
* A middle zone with distruction of parenchyma but with some
persistence of stroma
* A relatively normal liver tissue in which ameba can be
demonstrated
Treatment is with amebacidal drugs and surgery for drainage.
Any questions be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for your access and review.
Visitors that follow the site may post contributions to the site.
To introduce consumer/provider convergence visit http://bit.ly/cPTh6f
http://www.otmanage.blogspot.com/
Click on image to see detail.
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