Surgery

A patient underwent a dental procedure and subsequently develops jaundice and chills.

Ultrasound reveals a 6 cm hypoechoic lesion in the liver. What is the most appropriate initial management?

  1. A Oral antibiotics
  2. B Percutaneous drainage الإجابة الصحيحة
  3. C didn't recall
  4. D didn't recall

الشرح

Core Concept: Pyogenic liver abscesses can develop from hematogenous spread (e.g., following dental procedures or endocarditis), biliary tract disease, or direct extension from intra-abdominal infections.

Clinical Presentation:

  • Fever, chills, right upper quadrant pain, jaundice, weight loss, and hepatomegaly

Diagnosis:

  • First-line diagnostic plan: Abdominal ultrasound or CT scan with contrast showing a hypoechoic or hypodense fluid-filled lesion
  • Gold standard: Image-guided aspiration yielding purulent material with positive bacterial cultures

Management:

  • Acute management: Broad-spectrum intravenous antibiotics and prompt source control
  • Gold standard long-term management: Percutaneous catheter drainage under ultrasound or CT guidance is the standard of care for abscesses > 3-5 cm. Surgical drainage is reserved for ruptured abscesses, multiloculated cysts failing percutaneous drainage, or concurrent surgical pathology.

40 سؤالاً مجاناً مع حساب

الأسئلة المنشورة هنا عيّنة ثابتة. أنشئ حساباً مجانياً لتتدرب على بنك الأسئلة الكامل، مع تحليل أدائك حسب التخصص وصفحة لمراجعة أخطائك.

إنشاء حساب مجاني

بدون بطاقة دفع