Amebic Liver Abscess With Intra‐Biliary Rupture

Abstract

The case of a large amebic liver abscess with an atypical presentation is reported. High output bile drainage persisted after ultrasound guided percutaneous catheter drainage because of a preexisting communication of the abscess with the right hepatic ductal system. The abscess was managed successfully by surgical evacuation and internal drainage into a defunctioned jejunal loop.

Amebic liver abscess rupturing into the lesser omentum space

“…The mass was located between the liver and the pancreas, as if the mass had originated in the pancreas and was protruding into the liver. Although imaging examinations revealed signs of liver abscess in other previously reported cases, the present case showed no evidence of a liver abscess (Figs. ).…”

“…There have been many cases of an amebic liver abscess rupturing into the abdominal cavity and causing generalized peritonitis . Rare cases have been reported of rupture into the pericardial cavity, the pleural cavity,, the biliary tract,, a hepatic aneurysm, the retroperitoneum, the stomach, and the greater omentum, but there have been no reports of rupture into the lesser omentum producing a localized abscess.…”

Large Amoebic Liver Abscess with Persistent Biliary Fistula

“…The rarity of this complication is probably due to resistance offered by vasculobiliary sheath, a tough fibrous tissue level that surrounds the main and segmental portal structures: bile duct, hepatic artery, and portal vein. [3] ALA in the present case was diagnosed by positive serology, appearance of the pus, ultrasound, and CT scan of abdomen. The majority of ALA responds to conservative management.…”

Spontaneous Hepatogastric Fistula: A Rare Complication of Amebic Liver Abscess

“…4 Similarly, this case was also managed conservatively without any surgical or radiological intervention with complete resolution of the abscess. Operative strategies are recommended in hepatogastric fistula, 5 if the fistula fails to heal by conservative management or if there are features of peritonitis. Another case report of spontaneous hepatogastric fistula secondary to tubercular liver abscess also healed completely with antituberculosis treatment without any surgical intervention.…”