Clin Mol Hepatol.  2017 Mar;23(1):87-90. 10.3350/cmh.2016.0029.

Hepatogastric fistula as a rare complication of pyogenic liver abscess

• Lee KW
• Kim HY
• Kim CW
• Kim YK
• Kwon O
• Kim MA
• Cho Y
• Yang K

• KMID: 2412119
• DOI: http://doi.org/10.3350/cmh.2016.0029

Abstract

Hepatogastric fistula following a pyogenic liver abscess is extremely rare, and only a handful of cases have been reported. An 88-year-old female presented with generalized weakness, fever and chills. An abdominal computed tomography scan revealed a 5cm-sized hypodense lesion with internal septa in the left lateral section of the liver. Due to initial suspicion of early liver abscess, she was treated with empirical intravenous antibiotics. Initially, aspiration or drainage of the liver abscess was not performed due to immature lesion characteristics. An ultrasonography-guided percutaneous drainage of the liver abscess was performed 17 days after hospitalization due to a more mature lesion appearance on follow-up imaging. On tubography, contrast media leakage through the fistulous tract was visualized. Surgical management was performed, and she was discharged 2 weeks after surgery.

Keyword

Complication; Gastric fistula; Liver abscess; Pyogenic

MeSH Terms

Aged, 80 and over
Contrast Media/chemistry
Drainage
Female
Fistula/*diagnosis/etiology/pathology/surgery
Humans
Liver/diagnostic imaging
Liver Abscess, Pyogenic/complications/*diagnosis/pathology
Magnetic Resonance Imaging
Tomography, X-Ray Computed
Ultrasonography
Contrast Media