Abstract Ref Number = APCP869
LIVER ABSCESSES WITH SEVERE ANAEMIA SURVIVAL ON CONSERVATIVE THERAPY
I GUSTI ISTRI AGUNG WIDNYANI,I PUTU GEDE KARYANA,I GUSTI NGURAH SANJAYA PUTRA,NYOMAN METRIANI NESA
Child Health Dept Udayana University Med School Bali Indonesia
Background : Liver is an important and vital organ of the body. This organ is subjected to numerous systemic infections viral, bacterial, and parasitic and lies at the distal end of the portal circulation; it is therefore bathed with portal blood containing viruses, bacteria parasites, products of digestion and other antigens. Liver abscess are infectious, space-occupying lesions in the liver; the two most common abscesses being pyogenic and amoebic. Pyogenic liver abscess (PLA) is potentially lethal condition.
Case Presentation Summary : Six years old boy complained abdominal pain since 4 month before admitted to hospital. The abdomen began to stiff 23 days before. Since 4 weeks, there was several episode of fevers, more than 4 times but not more than 3 days, relieved by antipyretic. Every fever followed by stomachache. His parents said he looked more pale than before and his activities decreased, was sleepy and irritable. In physical examination we found patient looked anemic, with distended abdomen with hepatomegaly. Routine CBC revealed: WBC was 16.99, Hemoglobin was 5.45g/dL platelet was 796.20, iron parameters was: iron serum: 11.27 ug/dL (normal: 50-120 ug/dL) TIBC: 180 ug/dL(normal 225-450 ug/dL). A liver abcess 4.5 cm x 5.1 cm with liquefaction was obtained by ultrasound and confirmed by abdomen MSCT with contrast 4,4 x 4,3 x 6,1 cm. Abscess draining surgery was refused by patient family so only conservative therapy by antibiotics was given and further follow up in polyclinic. Nine month after therapy, follow up by ultrasound was normal.
Learning Points/Discussion : The sign and symptom of pyogenic LA was non specific, diagnosis was confirmed by abdomen MSCT with contrast. The prognosis was good.
Keywords: Liver abscess Pediatric Anaemia Conservative