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Case Reports
. 2025 Jan-Mar;15(1):87-91.
doi: 10.4103/jwas.jwas_160_23. Epub 2024 Aug 2.

A Diagnostic Dilemma of Emphysematous Liver Abscess with Gas under the Diaphragm: A Case Report and Review of Literature

Affiliations
Case Reports

A Diagnostic Dilemma of Emphysematous Liver Abscess with Gas under the Diaphragm: A Case Report and Review of Literature

Shubhajeet Roy et al. J West Afr Coll Surg. 2025 Jan-Mar.

Abstract

A 53-year-old woman presented to the surgical emergency with complaints of high-grade fever accompanied by chills for 15 days and pain in the right upper abdomen for 10 days. X-ray of the abdomen and chest X-ray revealed free gas under the right hemidiaphragm. As there were no signs of generalised or localised peritonitis, emergency laparotomy was postponed. Subsequently, a contrast-enhanced computerised tomography scan of the abdomen suggested an emphysematous liver abscess, which was managed by ultrasonography-guided drainage of the abscess cavity.

Keywords: Emphysematous liver abscess; Klebsiella pneumoniae; peritonitis; pigtail drainage; pneumoperitoneum.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Erect X-ray of the chest showing free gas under the right hemidiaphragm
Figure 2
Figure 2
CECT (axial view) of the abdomen showing free gas under the right hemidiaphragm, along with hepatomegaly. Additionally, two large cavities can be seen in the liver parenchyma in both lobes of the liver, along with a homogenous collection involving segments 8, 2, and 3 of the liver. Specks of air were present with air-fluid levels inside the hypodense lesions. CECT: contrast-enhanced computerised tomography

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References

    1. Smith RS. Pyogenic liver abscess in the aged. Am J Surg. 1944;63:206–13.
    1. Hagiya H, Kuroe Y, Nojima H, Otani S, Sugiyama J, Naito H, et al. Emphysematous liver abscesses complicated by septic pulmonary emboli in patients with diabetes: Two cases. Intern Med. 2013;52:141–5. - PubMed
    1. Lee HL, Lee HC, Guo HR, Ko W-C, Chen K-W. Clinical significance and mechanism of gas formation of pyogenic liver abscess due to Klebsiella pneumoniae . J Clin Microbiol. 2004;42:2783–5. - PMC - PubMed
    1. Lee CJ, Han SY, Lee SW, Baek YH, Choi SR, Roh MH, et al. Clinical features of gas-forming liver abscesses: Comparison between diabetic and nondiabetic patients. Korean J Hepatol. 2010;16:131–8. - PubMed
    1. Chou FF, Sheen-Chen SM, Chen YS, Lee TY. The comparison of clinical course and results of treatment between gas-forming and non-gas-forming pyogenic liver abscess. Arch Surg. 1995;130:401–5. - PubMed

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