Hepatogastric fistula as a rare complication of pyogenic liver abscess

• Main Authors: Kyu Won Lee, Hee Yeon Kim, Chang Wook Kim, Young Ki Kim, Ohbeom Kwon, Min Ah Kim, Youngyun Cho, Keungmo Yang
• Format: Article
• Language: English
• Published: Korean Association for the Study of the Liver 2017-03-01
• Series: Clinical and Molecular Hepatology
• Subjects: Complication; Gastric fistula; Liver abscess; Pyogenic
• Online Access: http://e-cmh.org/upload/pdf/cmh-2016-0029.pdf
• ISSN: 2287-2728; 2287-285X

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.