Liver Abscess in a Pediatric Patient with Ulcerative Colitis: A Case Presentation

Abstract

Hepatic abscesses are an uncommon extra-intestinal manifestation of inflammatory bowel disease, the incidence of which has been estimated to be approximately 7 per 10,000 patients with inflammatory bowel disease. It is unclear whether patients with Crohn's disease or patients with ulcerative colitis (UC) are at higher risk of developing this complication. Based on case reports, most cases are found in Crohn's disease; however, a recent cohort study showed an increased risk in UC instead. Hepatic abscesses in the pediatric population are rare, and there have been no reported cases of hepatic abscesses in a pediatric patient with UC. We describe herein a pediatric patient with UC who developed hepatic abscesses and portal vein thrombosis. This patient also had an extended time in remission from his UC despite being off of immunosuppressive therapies, and we speculate on how his clinical course and treatment strategies may have contributed to this.

Keywords: IBD; Liver abscess; Ulcerative colitis.

Fig. 1.. Alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransfarse (AST) trends of the patient.

Initial data points from office visits beginning September 19^th (9/19). Last data point from post-discharge follow-up data at the end of December (12/28).

Fig. 2.. Computed tomography (CT) of the abdomen with contrast done on admission.

This axial view demonstrates the largest loculation the patient had, located in the right hepatic lobe.