Conventional radiologic methods had given the limited informations about itraabdominal abscesses. Today,however, CT and ultrasongraphy provide detailed anatomic location, number and dimension of intraabdominal abscessand also permit percutaneous placement of catheter large enough to effect drainage. Percutaneous catheter drainageof intraabdominal abscess now offers an alternative to surgery. This simple method of mechanical drainage, whenemployed with systemic antibiotics, can be successful in treating the majority of intraabdominal abscesses.Authors analysed 24 cases of percutaneous abdominal abscess drainage performed at chonnam Natinal UniverstiyHospital from May 1985 to June 1986. The results were as follows: 1. The sites of abscesses; liver in 14cases(58.3%), psoas muscle in 3 cases(12.5%), subphrenic space in 3 cases (12.5%), pelvic cavity in 2 cases(8.3%),perirenal space in 2 cases(8.3%). 2. Complications during or after procedures were minor in the majority of cases.3. Average duration of drainage was as follows: 7.8days in liver abscess, 15.3 days in psoas abscess, 6 days inpelvic abscess, 7 days in subphrenic abscess.
Abdominal Abscess ; Abscess ; Anti-Bacterial Agents ; Catheters ; Drainage ; Jeollanam-do ; Liver ; Liver Abscess ; Methods ; Psoas Abscess ; Psoas Muscles ; Subphrenic Abscess

Some cases have reported that amebic colitis leads to serious complications that are caused by a misdiagnosis of an inflammatory bowel disease and consequential ill-managed steroid therapy. Therefore, it should be stressed that the differential diagnosis on such a case is very important. Eosinophilic colitis may reveal its presence as diarrhea, abdominal pain, ascites, and eosinophilic deposits in tissues. Therefore, it is highly necessary to make a differential diagnosis to distinguish eosinophilic colitis from other infectious or inflammatory bowel diseases. We report a case of amebic colitis, which was mistakenly diagnosed as eosinophilic colitis and a liver eosinophilic abscess in a young male who complained of bloody diarrhea and right upper quadrant pain. However, the misdiagnosed steroid therapy did not aggravate the progress of the amebic infection.
Abdominal Pain ; Abscess ; Amoeba ; Ascites ; Colitis ; Diagnosis, Differential ; Diagnostic Errors ; Diarrhea ; Dysentery, Amebic ; Eosinophils ; Humans ; Inflammatory Bowel Diseases ; Liver ; Liver Abscess ; Male ; Steroids

An 83-year-old female patient visited the emergency department for abdominal pain and dyspnea with hemodynamic instability. Abdominal computed tomography showed multiple liver abscesses and a large volume of pericardial effusion. A transthoracic echocardiography revealed features suggestive of cardiac tamponade, including massive pericardial effusion and diastolic collapse of the right atrial wall. Emergency percutaneous pericardial drainage and percutaneous transhepatic drainage were performed. Klebsiella pneumoniae (KP) was isolated from both the pericardial effusion and bile. The first case of cardiac tamponade secondary to a liver abscess in Korea was reported in 1981, and it was caused by amoebal infection via fistula formation between the pericardium and abscess. We recently experienced a case of pyogenic liver abscess caused by KP complicating cardiac tamponade via direct invasion. This is an unusual complication of KP infection because KP is more frequently associated with hematogenous spread.
Abdominal Pain ; Abscess ; Bile ; Cardiac Tamponade ; Drainage ; Dyspnea ; Echocardiography ; Emergencies ; Female ; Fistula ; Hemodynamics ; Humans ; Klebsiella ; Klebsiella pneumoniae ; Korea ; Liver Abscess ; Liver Abscess, Pyogenic ; Pericardial Effusion ; Pericardium

A 72-year-old diabetic male patient with high grade fever, right upper quadrant abdominal pain and Klebsiella pneumoniae septicemia is reported. He suffered from high fever and abdominal pain in spite of aspiration of liver abscess and antibiotic treatment. A few days later, we found a palpable pulsating abdominal mass on physical examination. Computed tomography and angiography revealed infected abdominal aortic aneurysm associated with pyogenic liver abscess. He was treated by antibiotics and Endovascular stent without surgical resection. He improved without complications and has been followed-up after discharge with excellent condition. To our knowledge, this is the first case of infected abdominal aortic aneurysm as a septic metastatic lesion secondary to liver abscess.
Abdominal Pain ; Aged ; Aneurysm, Infected ; Angiography ; Anti-Bacterial Agents ; Aortic Aneurysm, Abdominal* ; Fever ; Humans ; Klebsiella pneumoniae ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Male ; Physical Examination ; Sepsis ; Stents*

Recent studies indicate that there is an increased risk of amebic liver abscess among those infected with HIV, which is associated with cell-mediated immunosuppression. Although Entamoeba histolytica infection is common among HIV infected patients, only a few cases of amebic liver abscess with bilateral pleural effusion have been reported. We present a case of a 44-year-old man who presented with fever and right lower quadrant abdominal pain. Amebic liver abscess with bilateral pleural effusion was confirmed by serologic test, clinical symptoms, and radiological findings. HIV infection was incidentally diagnosed during treatment. The possibility of the presence of amebic liver abscess should be considered in HIV infected patients with space-occupying lesions in the liver, and HIV screening should strongly be recommended in patients with amebic liver abscess.
Abdominal Pain ; Adult ; Entamoeba histolytica ; Fever ; HIV ; HIV Infections ; Humans ; Immunosuppression ; Liver ; Liver Abscess, Amebic ; Mass Screening ; Pleural Effusion ; Serologic Tests

Gas-forming pyogenic liver abscess (GFPLA) is very rare and has a very high mortality in case of rupture into the abdominal cavity, which usually require surgical treatment. We experienced a case of a ruptured GFPLA due to Klebsiella pneumoniae complicated with peritonitis and sepsis in a 68-year-old diabetic woman. Immediate and aggressive medical treatments including intravenous antibiotics, percutaneous drainage, and continuous renal replacement therapy dramatically improved the liver abscess, peritonitis, and metabolic problems. We report an unusual case of a ruptured GFPLA without surgical management, treated successfully with only medical treatment.
Abdominal Cavity ; Aged ; Anti-Bacterial Agents ; Drainage ; Female ; Humans ; Klebsiella pneumoniae ; Liver Abscess ; Liver Abscess, Pyogenic ; Mortality ; Peritoneal Cavity ; Peritonitis ; Renal Replacement Therapy ; Rupture ; Sepsis

Pneumoperitoneum is usually the result of a perforated gastrointestinal (GI) tract associated with peritonitis. However, on rare occasions, spontaneous pneumoperitoneum not associated with a perforated GI tract has been described in the literature. A ruptured liver abscess is one of these occasions, and herein a case that resulted in pneumoperitoneum is reported. A 61-year-old woman was referred to the ER with acute onset of abdominal pain. The patient had been diagnosed as having diabetes mellitus and hypertension. The abdominal examination was not remarkable for tenderness, but her vital signs were unstable. Laboratory investigations revealed a WBC count of 4, 000/mm3, Na+ of 129 mEq/L, and K+ of 3.2 mEq/L. A plain radiography disclosed a minute amount of free air in the left subphrenic space, and a computed tomography (CT) scan visualized a low-density cystic mass suspected to be a gas forming pyogenic liver abscess. A laparoscopic exploration was performed for diagnosis and peritoneal drainage. Under the laparoscopy, a ruptured liver abscess and large amount purulent plaque were observed scattered in the entire peritoneal cavity. Evacuation of the abscess, cholecystectomy, liver biopsies, and peritoneal lavage were carried out after conversion to an open laparotomy. An abscess culture was obtained from the liver, with Klebsiella pneumoniae revealed as the pathogen. The administration of appropriate antibiotics followed the surgery, and she recovered without complications. A ruptured pyogenic liver abscess is an extremely rare and threatening condition despite the advances in diagnostic technology and new strategies for their treatment. However, the appropriate surgical management, followed by effective antibiotic therapy, will recover the patient without serious complications.
Abdominal Pain ; Abscess ; Anti-Bacterial Agents ; Biopsy ; Cholecystectomy ; Diabetes Mellitus ; Diagnosis ; Drainage ; Female ; Gastrointestinal Tract ; Humans ; Hypertension ; Klebsiella pneumoniae ; Laparoscopy ; Laparotomy ; Liver ; Liver Abscess ; Liver Abscess, Pyogenic* ; Middle Aged ; Peritoneal Cavity ; Peritoneal Lavage ; Peritonitis ; Pneumoperitoneum ; Radiography ; Rupture, Spontaneous* ; Vital Signs

Hepatobronchial fistula, an anatomic communication between the liver parenchyma and the bronchial tree, is a rare condition, which usually develops as a complication of amoebiasis, hydatid cysts, and trauma. We report on a case of a pyogenic liver abscess complicated by a hepatobronchial fistula, which responded well to treatment with antibiotics and percutaneous drainage. A 36-year-old male patient presented with a two-week history of dry cough, shortness of breath, right side abdominal pain, and fever. Chest computed tomography scan showed a heterogeneously enhanced abscess measuring approximately 6 cm in the right liver dome. Percutaneous drainage was performed and antibiotics were administered against Group C Streptococcus cultured from the abscess. After nine days of therapy, repositioning of the drainage catheter was performed and the patient coughed suddenly during injection of contrast media, and communication from abscess to bronchus was discovered. While maintaining abscess drainage and antibiotic therapy, the fistula diminished gradually and disappeared completely with resolution of the liver abscess.
Abdominal Pain ; Abscess ; Adult ; Amebiasis ; Anti-Bacterial Agents ; Bronchi ; Bronchial Fistula ; Catheters ; Contrast Media ; Cough ; Drainage ; Dyspnea ; Echinococcosis ; Fever ; Fistula ; Humans ; Liver ; Liver Abscess ; Liver Abscess, Pyogenic ; Male ; Streptococcus ; Thorax

We have presented an analysis of cases of liver abscess from the record of the Department of Pediatrics, Yonsei medical College, during the 10 year 8 months period from Jan. 1969 through Sept. 1979. The incidence of admission in pediatric was 0.05025%. There was male preponderance. The most frequently encountered symptoms and sings were fever and chill, anorexia, hepatomegale, pain and tenderness on right upper quadrant of abdomen. The pathogenetic mechanisms were lodgement in the liver of hematogenously dissemination, ascending infection of cholangitis, trauma. Cryptogenic liver abscess was seen in two cases. There were 5 cases of pyogenic liver abscess and 3 cases of amebic liver abscess. Undetermined etiology was noted in 2 cases. Roentgenography including scan is the most helpful diagnostic tool available. Only one patient with post-traumatic liver abscess was expired.
Abdomen ; Anorexia ; Cholangitis ; Fever ; Humans ; Incidence ; Liver Abscess* ; Liver Abscess, Amebic ; Liver Abscess, Pyogenic ; Liver* ; Male ; Pediatrics ; Radiography

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.
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