5 Mar 2020

간농양 Liver abscess

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간농양 Liver abscess

간농양의 원인

  • 간에 생긴 농양을 간농양이라고 한다. 
  • 이질 아메바(Entamoeba histolytica) 등 원충 감염에 의해서 간에 농양이 생길 수 있다. 
  • 황색 포도상구균, 대장균, 클랩씨엘레균, 박테로이드스균, 엔트로콕사이드균, 또는 그 외 다른 종류의 박테리아 감염에 의해서 간에 농양이 생길 수 있다.

간농양의 증상 징후

  • 간농양을 일으키는 병원체에 따라 증상 징후가 다르다. 
  • 열, 복통, 황달, 체중감소, 구토, 구미상실, 피로 등이 생길 수 있다. 

간농양의 진단

  • 병력, 증상 징후, 진찰소견 등으로 간농양이 의심되면 CBC 피 검사, 소변, 대변 세균배양검사, 간 기능검사, 간 초음파 검사, 간 CT 스캔 검사 등으로 진단할 수 있다. 
  • 병소에서 피검물을 채취해 세균검사를 해서 진단한다. 
  • 아메바 감염에 의한 간농양은 아메바 항체검사로 진단할 수 있다. 

간농양의 치료 

  • 아메바 간농양은 Metronidazole이나 Tinidazole로 치료할 수 있다. 
  • 박테리아 감염으로 인한 간농양은 적절한 항생제로 치료하면서 고름을 수술로 빼서 치료한다.

liver-bile-2-1s.jpg

그림 248. 간농양.

화살표로 가리킨 간 부위에 간농양이 생겨 있다.

a-간, b-담낭, c-십이지장관 유두(담즙과 췌장액이 분비되는 출구), d-부신, e-좌 신장, f-지라, g-십이지장관, h-췌장, i-총수담관, j-혈관.

Copyright ⓒ 2012 John Sangwon Lee, MD, FAAP

 

Liver abscess 간농양

Causes of liver abscess

• An abscess that develops in the liver is called a liver abscess.

• Abscesses of the liver can be caused by protozoal infections such as Entamoeba histolytica.

• Abscesses of the liver can be caused by infection with Staphylococcus aureus, E. coli, Clapsiele, Bacteroids, Entrocoxide, or any other type of bacteria.

Symptoms signs of a liver abscess

• Symptoms differ depending on the pathogen causing the liver abscess.

• Fever, abdominal pain, jaundice, weight loss, vomiting, loss of mouth, and fatigue may occur.

Diagnosis of liver abscess

• If a liver abscess is suspected due to medical history, symptoms, and examination findings, it can be diagnosed with CBC blood test, urine, fecal bacterial culture test, liver function test, liver ultrasound, liver CT scan, etc.

• Diagnosis is performed by collecting a specimen from the lesion and performing a bacteriological test.

• Liver abscess caused by an amoeba infection can be diagnosed with an amoeba antibody test.

Treatment of liver abscess

• Amoeba liver abscess can be treated with Metronidazole or Tinidazole.

• Liver abscess caused by bacterial infection is treated by surgically removing pus while treating with appropriate antibiotics.

liver-bile-2-1s.jpg

Fig. 248. Liver abscess. A liver abscess has occurred in the area of ​​the liver indicated by the arrow. a-liver, b-gallbladder, c-duodenal duct papilla (exit from which bile and pancreatic fluid are secreted), d-adrenal, e-left kidney, f-spinal, g-duodenal duct, h-pancreas, i-common bile duct, j-blood vessels. Copyright ⓒ 2012 John Sangwon Lee, MD, FAAP

출처 및 참조 문헌 Sources and references

  • NelsonTextbook of Pediatrics 22ND Ed
  • The Harriet Lane Handbook 22ND Ed
  • Growth and development of the children
  • Red Book 32nd Ed 2021-2024
  • Neonatal Resuscitation, American Academy Pediatrics
  • www.drleepediatrics.com제7권 소아청소년 감염병
  • www.drleepediatrics.com제9권 소아청소년 소화기 질환
  •  Red book 29th-31st edition 2021
  • Nelson Text Book of Pediatrics 19th — 21st Edition
  • The Johns Hopkins Hospital, The Harriet Lane Handbook, 22nd edition
  • Childhood Emergencies in the Office, Hospital and Community, American Academy of Pediatrics
  • Emergency Medical Service for Children, By Ross Lab. May 1989. p.10
  • Emergency care, Harvey grant and Robert Murray
  • Emergency Care Transportation of Sick and Injured American Academy of Orthopaedic Surgeons
  • Emergency Pediatrics A Guide to Ambulatory Care, Roger M. Barkin, Peter Rosen
  • Immediate care of the acutely ill and injured, Hugh E. Stephenson, Jr
  • The Critically Ill Child, Diagnosis and Management, Edited by Clement A. Smith
  • Emergency Medical Services for Children: The Role of the Primary Care Provider, America Academy of Pediatrics
  • Quick Reference To Pediatric Emergencies, Delmer J. Pascoe, M.D., Moses Grossman, M.D. with 26 contributors
  • Manual of Emergency Care
  • 응급환자관리 정담미디어
  • 소아가정간호백과–부모도 반의사가 되어야 한다, 이상원
  • Neonatal Resuscitation American heart Association
  • Neonatology Jeffrey J.Pomerance, C. Joan Richardson
  • Pediatric Resuscitation Pediatric Clinics of North America, Stephen M. Schexnayder, M.D.
  • Pediatric Critical Care, Pediatric Clinics of North America, James P. Orlowski, M.D.
  • Preparation for Birth. Beverly Savage and Dianna Smith
  • Infectious disease of children, Saul Krugman, Samuel L Katz, Ann A. Gershon, Catherine Wilfert
  • The Harriet Lane Handbook 19th Edition
  • 소아과학  대한교과서
  • 제1권 소아청소년 응급의료 참조문헌과 출처
  • Other

Reviewed 2/2015

Copyright ⓒ 2015 John Sangwon Lee, MD, FAAP

“부모도 반의사가 되어야 한다”-내용은 여러분들의 의사로부터 얻은 정보와 진료를 대신할 수 없습니다.

“The information contained in this publication should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your doctor may recommend based on individual facts and circumstances. “Parental education is the best medicine.”