Spontaneous Pneumoperitoneum Secondary to the Rupture of a Gas-Containing Pyogenic Liver Abscess.
- Author:
Hee Jeoung KIM
1
;
Hyuk Jai JANG
;
Yong Pil CHO
;
Yong Ho KIM
;
Seung Mun JUNG
;
Jae Hong AHN
;
Myeng Sik HAN
Author Information
1. Department of Surgery, Ulsan University College of Medicine and Asan Medical Center, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Rupture of a gas-containing pyogenic liver abscess;
Pneumoperitoneum
- MeSH:
Abdomen, Acute;
Aged;
Diabetes Mellitus;
Diagnostic Errors;
Drainage;
Emergencies;
Female;
Gastrointestinal Tract;
Humans;
Laparotomy;
Liver;
Liver Abscess;
Liver Abscess, Pyogenic*;
Mortality;
Omentum;
Pneumoperitoneum*;
Radiography, Abdominal;
Rupture*;
Rupture, Spontaneous;
Thorax;
Ultrasonography
- From:Journal of the Korean Surgical Society
2004;66(1):60-63
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Herein, a rare case of a spontaneous rupture of a liver abscess, resulting in pneumoperitoneum, is reported. A 71-year old female with uncontrolled diabetes mellitus, developed an acute abdomen. The chest x-ray and plain abdominal radiography findings revealed bilateral subphrenic free air, and the computed tomography suggested the rupture of a gas-containing pyogenic liver abscess in the left hepatic lobe, extending to the lesser omentum. An emergency laparotomy was performed, there was a ruptured pyogenic liver abscess in the left lobe, but no perforation of the hallow viscus organ. A left lobectomy of the liver, with surgical drainage, was performed. The occurrence of pneumoperitoneum secondary to the intraperitoneal rupture of a pyogenic liver abscess, is extremely rare. The condition is associated with high mortality as they are often misdiagnosis at a late stage as a hollow viscus perforation. Recently advances in computed tomography and ultrasound have resulted in liver abscesses being detect earlier. It must be borne in mind that a rupture of a gas-containing liver abscess can also mimic a perforation of the gastrointestinal tract.
