1.A Case of Salmonella Liver Abscess.
Jeong Woo CHOI ; Sung Jun CHOI ; Hyeock Choon KWON ; Jae Youn CHEONG ; Ki Myung LEE ; Byeong Moo YOO ; Ki Baik HAHM ; Jin Hong KIM ; Sung Won CHO
The Korean Journal of Gastroenterology 2006;47(4):316-319
Liver abscess can be caused by bacterial, parasitic, or fungal infection. Amebic abscesses are more common, but pyogenic abscesses account for three quarters of hepatic abscess in developed countries. Most common pathogens of the pyogenic liver abscess are Escherichia coli, Klebsiella pneumoniae, Bacteroides, Enterococci, Streptococci, and Staphylococci. However, liver abscess caused by Salmonella species has rarely been reported. We experienced a case of Salmonella liver abscess which improved after antibiotic therapy and percutaneous drainage. The patient was 52 years-old man who had an episode of intermittent fever, chills and epigastric pain for 2 weeks. He was diagnosed as liver cirrhosis eight years ago and diabetes three years ago. Salmonella group D, non-typhi was cultured from blood and pus from the liver respectively at the same time. With percutaneous drainage and susceptible antibiotic therapy, liver abscess decreased in size with improvements in fever and abdominal pain.
Humans
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Liver/radiography/ultrasonography
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Liver Abscess, Pyogenic/*diagnosis/microbiology
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Male
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Middle Aged
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Salmonella Infections/*diagnosis
3.Spontaneous Pneumoperitoneum Secondary to the Rupture of a Gas-Containing Pyogenic Liver Abscess.
Hee Jeoung KIM ; Hyuk Jai JANG ; Yong Pil CHO ; Yong Ho KIM ; Seung Mun JUNG ; Jae Hong AHN ; Myeng Sik HAN
Journal of the Korean Surgical Society 2004;66(1):60-63
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
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Aged
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Diabetes Mellitus
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Diagnostic Errors
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Drainage
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Emergencies
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Female
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Gastrointestinal Tract
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Humans
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Laparotomy
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Liver
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Liver Abscess
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Liver Abscess, Pyogenic*
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Mortality
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Omentum
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Pneumoperitoneum*
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Radiography, Abdominal
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Rupture*
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Rupture, Spontaneous
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Thorax
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Ultrasonography