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(A) Ultrasonography demonstrated a linear hypoechoic structure (arrows) in an area of tissue breakdown in the left lobe of the liver. (B) Magnetic resonance imaging (MRI) showed a hypointense, coiled structure (arrows) in an abscess in the liver's left lobe. (C) MRI disclosed a linear hypointense structure—a worm, which is denoted by the arrow—in the abscess in the liver parenchyma. (D) MRI with contrast identified the liver abscess (asterisk) and the nonenhancing, hypointense worm (arrow).

A Worm Hole: Liver Abscess in Ascariasis

A patient with an infection that is often asymptomatic developed an uncommon complication. The 60-year-old woman presented with fever and pain in the epigastrium and right hypochondrium, symptoms that had existed for the previous 5 days. On touch, she was clearly febrile. Her temperature was 38.6°C (101.5°F). Her blood pressure and pulse rate were within […]

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Significant interstate variability exists in liver disease-related mortality. States' color and height represent liver disease mortality.

Geographic Variability in Liver Disease-Related Mortality Rates in the United States

Liver disease is an important cause of morbidity and mortality in the United States. Geographic variations in the burden of chronic liver disease may have significant impact on public health policies but have not been explored at the national level. The objective of this study is to examine interstate variability in liver disease mortality in […]

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Screening for Hepatocellular Carcinoma in Patients with Cirrhosis: A Need to Increase Awareness

Hepatocellular carcinoma is the most common primary liver cancer, occurring largely in patients with cirrhosis. The incidence of hepatocellular carcinoma is rising in the US, as is its mortality, making hepatocellular carcinoma one of the leading causes of cancer-related deaths in the country.1 Despite the fact that early detection improves survival in patients with hepatocellular carcinoma, […]

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Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease

Alcohol is a leading cause of liver disease worldwide. Although alcohol abstinence is the crucial therapeutic goal for patients with alcoholic liver disease, these patients have less access to psychosocial, behavioral, and/or pharmacologic treatments for alcohol use disorder. Psychosocial and behavioral therapies include 12-step facilitation, brief interventions, cognitive behavioral therapy, and motivational enhancement therapy. In […]

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Macrophage activation syndrome leading to massive hepatomegaly due to steatohepatitis and extreme hyperferritinemia in adult-onset Still's disease. (A), Marrow hemophagocytosis, showing macrophage ingestion of red blood cells (arrow). (B), Macrophage ingestion of leukocytes (arrow). (C), Massive hepatomegaly down to the pelvic brim. (D), Massive hepatosplenomegaly, with the liver showing minimal fluorodeoxyglucose uptake. (E), Liver biopsy showing mixed microvesicular and macrovesicular steatosis. (F), Immunohistochemical staining for CD3, showing that the scanty small lymphoid cells were mainly T cells, most likely to be reactive.

Pyrexia, Massive Hepatomegaly, and Extreme Hyperferritinemia

A 39-year-old woman presented with pyrexia. Extensive investigations showed negative results. On referral, she was febrile (41°C) and jaundiced, with a massive hepatomegaly to the pelvis. Clinical Summary Investigations showed a hemoglobin level of 9.3 g/dL, leukocyte level of 2.3×109/L, platelet level of 162×109/L, bilirubin level of 76 (4-23) μmol/L, alanine aminotransferase level of 94 […]

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Pyogenic Liver Abscess as the Initial Manifestation of Underlying Hepatocellular Carcinoma

The prognosis of patients who present with pyogenic liver abscess as the initial manifestation of underlying hepatocellular carcinoma is poor. In regions with a high prevalence of both pyogenic liver abscess and hepatocellular carcinoma, physicians should not ignore the possibility of underlying hepatocellular carcinoma in patients with risk factors. Abstract Background Pyogenic liver abscess and […]

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