Liver abscess secondary to intrahepatic gallbladder perforation

Abstract

Background-Aim: Hepatic abscess secondary to intrahe-patic gallbladder perforation is very rare and only few cases are published in the literature. Methods: We present our experience of management of three cases of liver abscesses secondary to intrahepatic gallbladder perforation. All the patients manifested right upper quadrant abdominal pain and fever, accompanied by chills and vomiting in the first patient, by septic shock in the second and by general weakness in the third patient. In all three patients, liver abscess was diagnosed by sonography and computer tomography scanning, and attributed to intrahepatic perforation of the gallbladder. All patients underwent cholecystectomy and drainage of the liver abscess, preceded by percutaneous abscess drainage in one patient. Results: The postoperative period was not uneventful, resulting in two patients being discharged on the 28th and 33nd postoperative day, while the third patient died on the 27th postoperative day owing to sepsis. Conclusion: Liver abscesses secondary to intrahepatic gallbladder perforation is a serious illness that must be managed immediately by cholecystectomy and abscess drainage, while concomitant diseases should also be addressed. Furthermore, the mortality and morbidity rates are high primarily because of delayed diagnosis.