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Case Reports
. 2013 Apr 22:2013:bcr2013009455.
doi: 10.1136/bcr-2013-009455.

A liver abscess presenting as bowel obstruction and perforation

Jan Rusman  1
Affiliations
Case Reports

A liver abscess presenting as bowel obstruction and perforation

Jan Rusman. BMJ Case Rep. .

Abstract

A 69-year-old cachexic man presented with tachycardia and hypotension on a background of 7 days of vomiting and constipation. He was not obviously in pain. He had a raised white cell count of 24.8×10(9)/l, and a lactate of 2.2 mmol/l. A chest x-ray had the appearance of free air under the diaphragm and he was suspected of having a bowel obstruction with perforation. An abdominal CT scan showed instead a large fluid and gas-filled hepatic abscess, and a second smaller simple cyst. The abscess was percutaneously drained, and the purulent fluid drained grew Streptococcus milleri. The patient was discharged home 2 weeks later.

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Figures

Figure 1
Figure 1
The chest radiograph with the appearance of free air under the diaphragm.
Figure 2
Figure 2
The abdominal CT scan showed a large liver abscess, with a second smaller simple cyst not shown.
See this image and copyright information in PMC

References

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