Isolated tuberculous liver abscess invading the abdominal wall: Report of a case

Abstract

Isolated tuberculous liver parenchymal and subcapsular abscesses are unusual,^but an abdominal wall abscess secondary to a tubercular liver abscess is extremely rare. To our knowledge, there is only one reported case of an abdominal wall abscess occurring secondary to a subcapsular liver abscess. We report the first documented case of direct invasion of the abdominal wall from an isolated tuberculous liver parenchymal abscess, diagnosed by imaging, surgical, and pathological findings. Although ultrasonography and computed tomography showed nonspecific hypoechoic and hypodense findings with peripheral contrast enhancement, T2-weighted magnetic resonance imaging (MRI) revealed a heterogeneous mass with characteristic hypointensity, suggesting the presence of free radicals produced by macrophages during active phagocytosis in tuberculosis. Although our case is extremely unusual, when hypointensity on T2-weighted MRI is seen, the possibility of tuberculosis should be considered and the results of polymerase chain reaction, culture, and histopathological diagnosis must be taken into account to avoid needless invasive surgery.

Pathological Assessment of Bovine Liver Abscesses in Basrah Abattoir, Iraq

“…The portal vein showed dilation as well to mononuclear leukocyte infiltration and congestion of the hepatic sinusoids, in addition to high proliferation and hyperplasia of the epithelial cells of the bile ducts and hepatic artery followed by fibrous capsule infiltrated with leucocytes. These results was followed those obtained previously [22] who are isolated tuberculous liver parenchymal and sub-capsular abscesses. In the present study, the abscess capsule showed severe infiltration of polymorphonuclear cells infiltration mainly neutrophils especially around the abscess capsules; Also there was a severe abscessation surrounded by inflammatory zone like a capsule.…”

Hepatobiliary Tuberculosis: Imaging Findings

“…Tuberculous abscesses may appear as hyperechoic solid lesions and may mimic a neoplastic disease [52]. CT shows fluid or pus collection in the liver parenchyma with an associated thick enhancing wall [61] (Fig. 8).…”

Primary Tubercular Liver Abscess Complicated by Tubercular Meningitis in Portal Cavernoma Cholangiopathy

“…Primary tubercular liver abscess (TLA) is an extremely rare condition, even in countries such as India, where TB is highly prevalent 2,3. Liver abscesses in portal cavernoma cholangiopathy (PCC) are predominantly pyogenic due to associated cholangitis.…”