Intra-operative mechanical ventilation in amebic liver absce
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A 42-year-old male patient of ruptured amebic liver abscess while undergoing surgery for the chronic empyema. A broncho-hepatic fistula was created probably by the institution of the positive pressure ventilation. Timely lung isolation using the in-situ double lumen tube (DLT) prevented the potentially life-threatening respiratory morbidity. The patient presented with complaints of fever for 1 month, pain in right upper abdomen and chest for 10 days. He had mild hepatomegaly associated with tenderness and guarding over right hypochondrium and decreased breath sounds in the right lower zone of the lung. All blood investigations were within normal limits except high leukocyte count (23,000/mm 3) and deranged coagulation (INR of 1.84). The ultrasound of abdomen and subsequent contrast enhanced computed tomography (CECT) showed a large hypoechoic collection measuring 11 cm × 17 cm in the right lobe of the liver, communicating with the right pleural cavity through a 1.3 cm long rent in the diaphragm along with minimal ascites. Ultrasound-guided aspiration from the collection tested positive for Entamoeba histolytica.....

http://www.joacp.org/article.asp?issn=0970-9185;year=2017;volume=33;issue=1;spage=125;epage=126;aulast=Kakkar
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