DOI: http://dx.doi.org/10.18203/2349-2902.isj20214400

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

Ajay Bhandarwar, Amarjeet Tandur, Geoffrey Kharmutee, Akshay Rathod, Kaustubh Dodke, Abhishek Rathod

Abstract


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.


Keywords


Pyogenic liver abscess, Cutaneous rupture, Biliary communication, Klebsiella pneumoniae, Image-guided percutaneous drainage, Endoscopic intervention

Full Text:

PDF

References


Chou FF, Sheen-Chen SM, Chen YS, Chen MC, Chen FC, Tai DI. Prognostic factors for pyogenic abscess of the liver. J Am Coll Surg. 1994;179(6):727-32.

Mischnik A, Kern WV, Thimme R. Pyogenic liver abscess: Changes of Organisms and Consequences for Diagnosis and Therapy. Dtsch Med Wochenschr. 2017;142(14):1067-74.

Altemeier WA, Culbertson WR, Fullen WD, Shook CD. Intra-abdominal abscesses. Am J Surg. 1973;125(1):70-9.

Mischinger HJ, Hauser H, Rabl H, Quehenberger F, Werkgartner G, Rubin R, Deu E. Pyogenic liver abscess: studies of therapy and analysis of risk factors. World J Surg. 1994;18(6):852-7.

Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston ‘Text Book of Surgery’. Vol-II. Elsevier India. 2016.

Wang JH, Liu YC, Lee SS, Yen MY, Chen YS, Wang JH, Wann SR, Lin HH. Primary liver abscess due to Klebsiella pneumoniae in Taiwan. Clin Infect Dis. 1998;26(6):1434-8.

Yang CC, Chen CY, Lin XZ, Chang TT, Shin JS, Lin CY. Pyogenic liver abscess in Taiwan: emphasis on gas-forming liver abscess in diabetics, Am J Gastroenterol. 1993;88:1911-5.

Bertel CK, van Heerden JA, Sheedy PF. Treatment of pyogenic hepatic abscesses: Surgical vs percutaneous drainage. Arch Surg. 1986;121:554-8.

Giorgio A, Tarantino L, Mariniello N, Francica G, Scala E, Amoroso P, Nuzzo A, Rizzatto G. Pyogenic liver abscesses: 13 years of experience in percutaneous needle aspiration with US guidance. Radiology. 1995;195(1):122-4.

Seeto RK, Rockey DC. Pyogenic liver abscess: changes in etiology, management, and outcome. Medicine (Baltimore). 1996;75:99-113.

Su YJ, Lai YC, Lin YC. Treatment and prognosis of pyogenic liver abscess. Int J Emerg Med. 2010;3:381-4.

Cerwenka H. Pyogenic liver abscess: differences in etiology and treatment in Southeast Asia and Central Europe. World J Gastroenterol. 2010;16:2458-62.

Lee CH, Leu HS, Wu TS, Su LH, Liu JW. Risk factors for spontaneous rupture of liver abscess caused by Klebsiella pneumoniae. Diagn Microbiol Infect Dis. 2005;52(2):79-84.

Lampropoulos CE, Papaioannou I, Antoniou Z. Multiple, large pyogenic liver abscesses treated conservatively: a case-report and review of the literature. GE J Port Gastrenterol. 2013;20(1):21-4.

Motoyama T, Ogasawara S, Chiba T. Successful non-surgical treatment of ruptured pyogenic liver abscess. Intern Med. 2013;52(23):2619-22.

Skouras C, Mole DJ. Benign liver lesions. Surgery. 2014;32(12):648-54. Lung J, Khan A, Malone ML. Pyogenic liver abscess in a frail older adult. J Am Geriatr Soc. 2014;62(2):408-9.

Sharma BC, Garg V, Reddy R. Endoscopic management of liver abscess with biliary communication. Dig Dis Sci. 2012;57(2):524-7.

Chou FF, Sheen-Chen SM, Lee TY. Rupture of pyogenic liver abscess. Am J Gastroenterol. 1995;90(5):767-70.

Belabbes S, El Barni R, El Kharras A. Anterior abdominal wall abscess revealing a pyogenic liver abscess: a case report. Research. 2014;1:1256.

Zizzo M, Zaghi C, Manenti A, Luppi D, Ugoletti L, Bonilauri S. Abdominal wall abscess secondary to spontaneous rupture of pyogenic liver abscess. Int J Surg Case Rep. 2016;25:110-3.

Kawoosa NU, Bashir A, Rashid B. Spontaneous Cutaneous Rupture of a Pyogenic Liver Abscess. Indian J Surg. 2010;72(4):339-42.