E-ISSN 2367-699X | ISSN 2367-7414
Required files to uploaded
|Case Report|| |
MULTIPLE HEPATIC ABSCESSES FROM A RUPTURED GALLBLADDER EMPYEMA A CASE REPORT AND REVIEW OF THE LITERATURE
Ayodele Atolagbe, Oloruntobi Rahaman.
An unusual complication of gallbladder empyema is its rupture into the liver forming giant multiloculated pyogenic abscesses. This condition is rapidly fatal in diabetic and immunocompromised patients.
We present a 79-year-old African American woman resident in New York City with a medical history of diabetes mellitus who presented at the ED with constitutional symptoms and right upper quadrant pain of a few days duration. She was tender and had a positive murphys sign on clinical examination coupled with tachycardia and a low-grade fever. Laboratory findings of leukocytosis, and metabolic acidosis, lactic academia and elevated ketones with moderately deranged hepatic function tests and negative tumor markers. Management consisted of broad spectrum antibiotics and an urgent open cholecystectomy and drainage of multiple multi-loculated hepatic abscesses. A repeat ultrasonogram showed a remnant collection which was drained by interventional radiology and drains left in-situ. She was discharged after four weeks of parenteral antibiotics with repeat sonogram showing complete resolution of hepatic abscess.
pyogenic hepatic abscess gallbladder, pyogenic abscess of the liver, pyogenic liver abscess, pyogenic hepatic abscess treatment, pyogenic hepatic abscess drainage
| || |
|1. Heneghan HM, Healy NA, Martin ST, Ronan SR, Niamh N, Oscar T, Ronan W. Modern Management of Pyogenic Hepatic Abscess: a case series and review of the literature. BMC Research Notes. 2011; 4:80 [DOI via Crossref] [Pubmed] [PMC Free Fulltext] |
|2. Donati M, Biondi A, Francesco B, Gruttadauria S. An atypical presentation of intra-hepatic perforated choelcystitis: a modern indication to open cholecystectomy. Report of a case. BMC Surg. 2014; 14: 6. [DOI via Crossref] [Pubmed] [PMC Free Fulltext] |
|3. Kochar K, Valance K, Matthew G, Jadhao V. Intra-hepatic perforation of the gallbladder presenting as a liver abscess: case report Eur J Gastroenterol. Hepatol. 2008; 240-4|
|4. Anderson BB, Nazem A. perforations of the gallbladder and cholecystobiliary fistulae: a review of management and a new classification J. NaH Med Assoc.1987; 393-9|
|5. Neimeier OW. Acute free perforation of the gallbladder Ann. Surg.1934; 99: 922-4|
|6. Singal R, Mittal A, Gupta S, Singh B, Jain P. Management of gall bladder perforation evaluation on Ultrasonography: report of six rare cases with review of literature. J Med Life. 2011; 4(4):364-371|
|7. Singal R, Gupta S, Singal RP, Mittal A, Sharma S, Khurana R. Gall Bladder Perforation Leads to Liver Abscess Formation - Role of Ultrasonography. J Gastrointest Dig Syst 2015; 5:279|