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Case Reports
. 2024 Mar:116:109343.
doi: 10.1016/j.ijscr.2024.109343. Epub 2024 Feb 2.

A case report and treatment considerations for pyogenic liver abscess with biliary fistula

Abdirahman Ahmed Omar Alasso  1 , Ismail Gedi Ibrahim  2 , Ismail Ahmed Ali  3 , Mohamed Rage Ahmed  2
Affiliations
Case Reports

A case report and treatment considerations for pyogenic liver abscess with biliary fistula

Abdirahman Ahmed Omar Alasso et al. Int J Surg Case Rep. 2024 Mar.

Abstract

Introduction and importance: Pyogenic liver abscess (PLA) is a potentially life-threatening condition characterized by the formation of space-occupying lesions within the liver parenchyma. Despite advancements in diagnostic imaging and antibiotic therapies, complications such as biliary fistula formation can arise, posing challenges in management.

Case presentation: This case study presents a 23-year-old male patient with PLA complicated by a biliary fistula. Diagnostic imaging via CT scan and MRI confirmed a liver abscess and biliary dilation. The patient underwent a second drainage for ascitic fluid following the initial percutaneous liver catheter drainage.

Clinical discussion: The patient responded positively to the treatment, with reduced abscess size and fistula resolution. While endoscopic interventions offer promising results, their limited availability necessitates alternative treatment strategies, such as percutaneous drainage and appropriate antibiotics.

Conclusion: This case emphasises the importance of individualized management approaches for PLA complicated by biliary fistulas. Despite the challenges, successful outcomes can be achieved through careful management and appropriate treatment strategies.

Keywords: Biliary fistula; Case report; Complication; Liver abscess; Pyogenic.

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Conflict of interest statement

Conflict of interest statement The author(s) do NOT have any potential conflicts of interest with respect to this manuscript.

Figures

Fig. 1
Fig. 1
The first post-intravenous contrast MSCT abdomen axial cut shows a relatively well-defined cystic focal lesion in segment VI of the right hepatic lobe (black arrow), which is a hepatic abscess. The lesion is associated with mild biliary dilatation(white arrow).
Fig. 2
Fig. 2
2nd post, the MSCT scan of the abdomen with oral contrast showed an abnormal air density in segment VI of the right hepatic lobe as well as mild splenomegaly and Ascetic collection. Percutaneous drainage is visible within the collection (black arrow).
Fig. 3
Fig. 3
MRI abdomen T2 axial cuts show a heterogeneous focal lesion in the right hepatic lobe, mild ascites, and dilated biliary channels.
See this image and copyright information in PMC

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