A rare case report on neonatal complications from Nepal: solitary neonatal hepatic abscess

Author:

Yogi Barurendra R.1,Basnet Bal M.2,Thapa Sajina3ORCID,Bohara Sujan4ORCID

Affiliation:

1. Department of Surgery, Shree Birendra Military Hospital

2. Department of Pediatrics, Kanti Children’s Hospital

3. Nepalese Army Institute of Health Sciences, Kathmandu

4. Department of General and Gastrointestinal Surgery, Nepal Mediciti Hospital, Lalitpur, Nepal

Abstract

Introduction and Importance: Neonatal liver abscess is a rare condition with a high mortality rate. However, in a low-resource setting, high clinical vigilance and the use of readily accessible diagnostic modalities can help in early diagnosis and, along with appropriate medical management, prevent lethal complication. Case presentation: We present the case of a patient who presented with one day of sudden abdominal distension and two episodes of projectile nonbilious vomiting. A solitary liver abscess was diagnosed using ultrasonography and contrast-enhanced computed tomography findings, and the patient was treated conservatively with parenteral broad-spectrum antibiotics. Following the completion of the antibiotic dose, an ultrasound of the abdomen reveals that the size of the liver abscess has decreased. Clinical discussion: Neonatal liver abscess is a rare clinical condition that causes significant morbidity and mortality in premature and term babies. In a neonate with potential risk factors, a high index of suspicion is required to make the diagnosis. Baseline tests, as well as computed tomography with or without contrast, aid in the definitive diagnosis of a hepatic abscess. For management, a multidisciplinary approach should be considered, including correction of the predisposing factor as well as appropriate medical and/or surgical intervention. Conclusion: Neonatal liver abscess is frequently overlooked due to its rarity. Thus, whenever a neonate exhibits the aforementioned clinical spectrum, it should be considered in the differential diagnosis, and a diagnostic workup and treatment should be initiated as soon as possible to avoid debilitating complications.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference10 articles.

1. Liver abscess: increasing occurrence in premature newborns;Bosnali;J Neonatal Surg,2013

2. Liver abscess in a term baby: a case report and review of literature;Ur Rahman;Dr Sulaiman Al Habib Med J,2019

3. Case report of multiple hepatic microabscesses in a term neonate;Bafna;Can Fam Physician,2001

4. Liver abscess in early infancy with no underlying risk factors: a case series;Anand;Trop Doct,2021

5. Neonatal liver abscess with impending rupture presenting as abdominal wall swelling: a rare case;Singh;J Clin Neonatol,2017

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