A case of hepatocolic fistula after percutaneous drainage for a gas-containing pyogenic liver abscess

Pyogenic liver abscess (PLA) is a rare extraintestinal complication of Crohn’s disease (CD), and the clinical and laboratory findings may emulate the reactivation of CD, therefore, delaying diagnosis. In this paper the patient presented with PLA as the initial manifestation of CD and experienced severe disease. The finding of PLA was established by computed tomography and initial treatment involved percutaneous drainage and antibiotics. The diagnosis of CD was made after colonoscopy and histological investigations.

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HEPATECTOMY FOR PYOGENIC LIVER ABSCESS TREATMENT: EXCEPTION APPROACH?

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020180001e1394 ◽

2018 ◽

Vol 31 (3) ◽

Author(s):

Sergio Renato PAIS-COSTA ◽

Sergio Luiz Melo ARAUJO ◽

Victor Netto FIGUEIREDO

Keyword(s):

Liver Abscess ◽

Percutaneous Drainage ◽

Therapeutic Option ◽

Hepatic Abscess ◽

Pyogenic Liver Abscess ◽

Surgical Approaches ◽

Morbidity Rate ◽

Median Hospital Stay ◽

The Mean

ABSTRACT Background: Percutaneous drainage for pyogenic liver abscess has been considered the gold-standard approach for the treatment on almost of the cases. However, when percutaneous drainage fails or even in some especial situations, as multiloculate abscess, lobe or segment surgical resection can solve infectious clinical condition. Aim: To report a series of patients who underwent hepatectomy for pyogenic liver abscess performed by a single surgical team. Methods: Eleven patients were operated with ages ranging from 45-73 years (mean and median 66 years). There were eight men and three women. The etiologies were: idiopathic (n=4), biliary (n=2), radiofrequency (n=2), direct extension (n=1), portal (n=1), and arterial (n=1). The mean lesion diameter was 9.27 cm (6-20 cm). Results: The mean operation length was 180 min (120-300). The mean intra-operative blood loss was 448 ml (50-1500). Surgical approaches were: right hepatectomy (n=4), left hepatectomy (n=3), left lateral sectioniectomy (n=1), right posterior sectioniectomy (n=2), resection of S8 (n=1), and S1 (n=1). Postoperative morbidity rate was 30%, while mortality was null. Median hospital stay was 18 days (5-45). The median follow-up period was 49 months (13-78). There was single lesion recurrence. Conclusion: Hepatectomy can be done as exception approach for pyogenic hepatic abscess treatment; it is a good therapeutic option in special situations.

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Spontaneous rupture of liver abscess with biliary communication presenting as a lumbar mass

International Surgery Journal ◽

10.18203/2349-2902.isj20214400 ◽

2021 ◽

Vol 8 (11) ◽

pp. 3484

Author(s):

Ajay Bhandarwar ◽

Amarjeet Tandur ◽

Geoffrey Kharmutee ◽

Akshay Rathod ◽

Kaustubh Dodke ◽

...

Keyword(s):

Liver Abscess ◽

Percutaneous Drainage ◽

Spontaneous Rupture ◽

Pyogenic Liver Abscess ◽

Primary Treatment ◽

Minimal Invasive ◽

Endoscopic Management ◽

Primary Treatment Modality ◽

Biliary Communication ◽

Minimal Invasive Techniques

Pyogenic liver abscess was first reported in the writings of Hippocrates, which was based on the type of fluid recovered from the abscess related to a high mortality rate ranging between 15% and 19% at that time. However in 1938, Ochsner and De Bakey described the recommended surgical treatment as the primary treatment modality. Surgery remained the therapy of choice until the mid-1980s, when percutaneous drainage was shown to be a safer alternative in many cases. Spontaneous rupture of liver abscess may occur free in the peritoneal cavity or in neighbouring organs, an event which is generally considered as a surgical emergency, while localized rupture can be managed with drainage, either percutaneous or surgical/minimal invasive techniques and addition of appropriate antibiotic treatment. In cases where there is uneventful rupture of abscess and localized to the neighbouring organs and tissues can be successfully treated by a combination of broad-spectrum antibiotics and percutaneous drainage and endoscopic management.

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Fusobacterium Nucleatum : An Atypical Cause of Pyogenic Liver Abscess in an Apparently Immunocompetent Patient

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v20i1.1769 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Yusoff AR ◽

Abd Razak NA ◽

Samsuddin S ◽

Mokhtar S

Keyword(s):

Liver Abscess ◽

Percutaneous Drainage ◽

Fusobacterium Nucleatum ◽

Pyogenic Liver Abscess ◽

Enteric Bacteria ◽

Operative Management ◽

Immunocompetent Patient ◽

Immunocompromised Status ◽

Anaerobic Infections ◽

Non Operative Management

Pyogenic liver abscess is an uncommon but potentially lethal infection if left untreated. Enteric bacteria and anaerobes are the most common causative organisms of pyogenic liver abscess. Although most infections are of a polymicrobial nature, monomicrobial infections are possible. An immunocompromised status and the presence of periodontal disease are the risk factors for liver abscess caused by these rare, monomicrobial anaerobic infections. Here, we report on a successful non-operative management of a case of multiloculated pyogenic liver abscess caused by Fusobacterium nucleatum in a young, healthy, immunocompetent male patient. The diagnosis was established by radiological imaging and was based on a positive aspirate culture, whereas the mainstay of treatment comprised percutaneous drainage and a prolonged course of antibiotics. Thus, the patient was successfully treated with a 2-week course of intravenous imipenem/cilastatin while he was on percutaneous drainage, and he is now doing well.

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Successful Percutaneous Drainage of Pyogenic Liver Abscess Complicated by Bronchobiliary Fistula

Southern Medical Journal ◽

10.1097/00007611-198707000-00024 ◽

1987 ◽

Vol 80 (7) ◽

pp. 907-909 ◽

Cited By ~ 4

Author(s):

THOMAS V. BILFINGER ◽

KEITH T. OLDHAM ◽

THOM E. LOBE ◽

SCOTT BARRON ◽

C KEITH HAYDEN

Keyword(s):

Liver Abscess ◽

Percutaneous Drainage ◽

Pyogenic Liver Abscess ◽

Bronchobiliary Fistula

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Clinical profile and management of pyogenic liver abscesses in a tertiary care hospital

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195643 ◽

2019 ◽

Vol 8 (1) ◽

pp. 52 ◽

Cited By ~ 1

Author(s):

Shyam K. Gupta ◽

Ashufta Rasool ◽

Aamir H. Hela ◽

Rohit Goel ◽

Zahur Hussain

Keyword(s):

Liver Abscess ◽

Percutaneous Drainage ◽

Tertiary Care ◽

Management Strategies ◽

Standard Of Care ◽

Pyogenic Liver Abscess ◽

Modern World ◽

Care Hospital ◽

Medical College ◽

Liver Abscesses

Background: Pyogenic Liver abscesses are potentially life threatening if left untreated. They pose a major Diagnostic and therapeutic challenge to modern world. Interventional radiology is becoming standard of care for liver Abscesses.Methods: All patients of pyogenic liver abscess admitted to Government Medical College and hospital Jammu, J and K, India from October 2018 to November 2019 were prospectively studied. Demographics, presentation, lab reports and management strategies were evaluated.Results: Total of 60 patients of pyogenic liver abscesses were studied with 81.7% males. Alcohol was found to be most common risk factor with 55% of patients being alcoholic. Right lobe of liver was involved in 66.7% of patients. Segment VI and VII were involved in 50% of patients. The most common clinical symptom was right upper quadrant pain (98.3%), followed by fever (91.7%). The most common clinical sign was right upper quadrant tenderness (91.7%). Percutaneous drainage with catheter placement was the most common and successful modality of management associated with least hospital stay.Conclusions: Pyogenic liver abscess is a rare but serious problem. Early diagnosis and treatment are necessary to avoid mortality. Percutaneous drainage along with I.V antibiotics is the best form of management.

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PYOGENIC LIVER ABSCESS: DIAGNOSTIC AND THERAPEUTIC MANAGEMENT

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-6720201600030015 ◽

2016 ◽

Vol 29 (3) ◽

pp. 194-197 ◽

Cited By ~ 11

Author(s):

Otto Mauro dos SANTOS-ROSA ◽

Henrique Simonsen LUNARDELLI ◽

Marcelo Augusto Fontenelle RIBEIRO-JUNIOR

Keyword(s):

Liver Abscess ◽

Percutaneous Drainage ◽

Clinical Manifestations ◽

Biliary Tract Disease ◽

Positive Association ◽

High Sensitivity ◽

Pyogenic Liver Abscess ◽

Treatment Method ◽

Significant Positive Association ◽

Epidemiological Characteristics

ABSTRACT Background: The pyogenic liver abscess has an incidence of 1.1/1,000 habitants. Mortality can reach 100%. The use of less invasive procedures diminish morbidity and hospital stay. Aim: Identify risk factors in patients who underwent percutaneous drainage guided by ultrasound as treatment. Method: Were analyzed 10 patients submitted to the method. Epidemiological characteristics, laboratory markers and imaging exams (ultrasound and CT) were evaluated. Results: The majority of the patients were men with mean age of 50 years old. Liver disease, alcoholism and biliary tract disease were the most common prodromes. Abdominal pain (90%), fever (70%) and jaundice (40%) were the most common clinical manifestations. Mortality of 20% was observed in this series. Hypoalbuminemia and days of hospitalization had a statistically significant positive association with death. Conclusion: The pyogenic liver abscess has subacute evolution which makes the diagnosis difficult. Image exams have high sensitivity in diagnosis, particularly computed tomography. Percutaneous drainage associated with antibiotic therapy is safe and effective therapeutic resource.

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Propionibacterium acnesPyogenic Liver Abscess and Pylephlebitis

Case Reports in Hepatology ◽

10.1155/2011/536167 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3

Author(s):

Arash Poursina ◽

Sharon Weissman

Keyword(s):

Portal Vein ◽

Adult Patient ◽

Liver Abscess ◽

Antimicrobial Therapy ◽

Pure Culture ◽

Percutaneous Drainage ◽

Unusual Case ◽

Propionibacterium Acnes ◽

Pyogenic Liver Abscess ◽

Septic Thrombophlebitis

Reported is an unusual case of pyogenic liver abscess and septic thrombophlebitis of the portal vein in a 44-year-old male caused byPropionibacterium acnessuccessfully managed with a combination of percutaneous drainage and antimicrobial therapy. To the best of our knowledge, this is the first report of this bacterium isolated in pure culture as the sole etiologic organism of pyogenic liver abscess and pylephlebitis in an adult patient.

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