A case of emphysematous hepatitis with spontaneous pneumoperitoneum in a patient with hilar cholangiocarcinoma.
10.3350/kjhep.2012.18.1.94
- Author:
Jung Ho KIM
1
;
Eul Sik JUNG
;
Seok Hoo JEONG
;
Ju Seung KIM
;
Yang Suh KU
;
Ki Baik HAHM
;
Ju Hyun KIM
;
Yeon Suk KIM
Author Information
1. Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea. drkim@gilhospital.com
- Publication Type:Case Reports
- Keywords:
Cholangiocarcinoma;
Rupture;
Hepatitis;
Necrosis;
Pneumoperitoneum
- MeSH:
Aged, 80 and over;
Anti-Bacterial Agents/therapeutic use;
Bile Duct Neoplasms/complications/diagnosis;
Bile Ducts, Intrahepatic/pathology;
Cefotaxime/therapeutic use;
*Cholangiocarcinoma/complications/diagnosis;
Clostridium Infections/drug therapy/microbiology;
Clostridium perfringens/isolation & purification;
Emphysema/complications/*diagnosis;
Escherichia coli/isolation & purification;
Escherichia coli Infections/drug therapy/microbiology;
Female;
Hepatitis/complications/*diagnosis;
Humans;
Metronidazole/therapeutic use;
*Pneumoperitoneum/complications/diagnosis;
Tomography, X-Ray Computed
- From:The Korean Journal of Hepatology
2012;18(1):94-97
- CountryRepublic of Korea
- Language:English
-
Abstract:
An 80-year-old woman with hilar cholangiocarcinoma was hospitalized due to sudden-onset abdominal pain. Computed tomography revealed hepatic necrosis accompanied with emphysematous change in the superior segment of the right liver (S7/S8), implying spontaneous rupture, based on the presence of perihepatic free air. Although urgent percutaneous drainage was performed, neither pus nor fluids were drained. These findings suggest emphysematous hepatitis with a hepatic mass. Despite the application of intensive care, the patient's condition deteriorated rapidly, and she died 3 days after admission to hospital. Liver gas has been reported in some clinical diseases (e.g., liver abscess) to be caused by gas-forming organisms; however, emphysematous hepatitis simulating emphysematous pyelonephritis is very rare. The case reported here was of fatal emphysematous hepatitis in a patient with hilar cholangiocarcinoma.
