Synchronous pyogenic liver abscess and acute cholecystitis: how to recognize it and what to do (emergency cholecystostomy followed by delayed laparoscopic cholecystectomy)

Costi, Roberta; Bian, Alban Le; Cauchy, François; Diop, P. S.; Carloni, Alessio; Catherine, L.; Smadja, Claude

doi:10.1007/s00464-011-1856-1

Cited by 9 publications

(16 citation statements)

References 28 publications

(44 reference statements)

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“…Elective cholecystectomy after cholangitis treatment is a feasible option as per Tokyo guidelines [16]. Other studies showed that drainage followed by delayed surgery is an acceptable treatment for cholecystitis concomitant with liver abscess [17,18].…”

Section: Discussionmentioning

confidence: 99%

First Schistosomal Cholecystitis Complicated by Cholangitis and Liver Abscess: Case Report and Review of Literature

Toffaha

Hyassat

Elmoghazy

et al. 2021

Case Reports in Surgery

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Schistosomiasis is one of the most prevalent parasitic infections in the developing world. When it affects the gastrointestinal system specifically the liver, it causes periportal fibrosis followed by cirrhosis. Cholecystitis however is a rare presentation, and associated liver abscess has certainly never been reported to date. We report a case of acute cholecystitis complicated by cholangitis and liver abscess in a 46-year-old man. After complex course of treatment, he had laparoscopic cholecystectomy, and the histology report confirmed schistosomiasis. Gallbladder schistosomiasis is an uncommon disease that is associated with dense fibrotic changes that strongly mimics xanthogranulomatous cholecystitis. Liver abscess may occur during the disease evolution especially in patient originating from endemic backgrounds. We present the case and a comprehensive literature review.

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Section: Discussionmentioning

confidence: 99%

First Schistosomal Cholecystitis Complicated by Cholangitis and Liver Abscess: Case Report and Review of Literature

Toffaha

Hyassat

Elmoghazy

et al. 2021

Case Reports in Surgery

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“…Several risk factors for PLAs, except for biliary disease have been identified, such as cirrhosis, diabetes mellitus, liver transplantation and malignancy. Diabetes mellitus has been estimated to complicate the clinical course of half of the patients that are treated for PLA and in need of treatment in an intensive care unit [1,41].…”

Section: Discussionmentioning

confidence: 99%

“…A pyogenic liver abscess (PLA) is a rather rare entity with an increasing level of occurrence in western countries ranging from 1.1/100,000 to 3.6/100,000 people, and a substantial mortality rate which is estimated to be between 5.6 and 10%. Mortality may even reach 22% when there are multiple PLAs [1,2]. The formation of a PLA is associated with cholelithiasis in as many as 15% of patients and with biliary disease in general in up to 21.9% of patients.…”

Section: Introductionmentioning

confidence: 99%

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Pyogenic Liver Abscess Complicating Acute Cholecystitis: Different Management Options

Paramythiotis

Karakatsanis²,

Karlafti³

et al. 2022

Medicina

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Acute cholecystitis, which is usually associated with gallstones is one of the most common surgical causes of emergency hospital admission and may be further complicated by mural necrosis, perforation and abscess formation. Perforation of the gallbladder is a relatively uncommon complication of acute cholecystitis (0.8–3.2% in recent reviews). The intrahepatic perforation causing a liver abscess is an extremely rare condition, anecdotally reported in the scientific literature, even in the rare types of subacute or acute perforation. Liver abscess caused by gallbladder perforation can be a life-threatening complication with a reported mortality of 5.6%. The treatment of synchronous pyogenic liver abscess and acute cholecystitis may be challenging. We reported three cases of liver abscess due to acute cholecystitis in which different therapeutical approaches were employed. The first case was treated with antibiotics and interval laparoscopic cholecystectomy; the second case was treated with emergency cholecystectomy; and the third case with percutaneous aspiration of the abscess only. The appropriate therapeutical method in these cases depends on the patient’s clinical condition, the on-site expertise that is available in the hospital, and the experience of the surgeon.

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“…Pyogenic abscesses may be bacterial or fungal. They often can be attributed to bacterial infections of the biliary tree such as cholangitis,9 or more distally in the body such as diverticulitis or inflammatory bowel disease,10 where infection may migrate to the liver via the portal vein system. Bacterial endocarditis, dental infections, fungal infections, cirrhosis,11 blunt trauma12 and foreign bodies13 are other causes.…”

Section: Discussionmentioning

confidence: 99%

A liver abscess presenting as bowel obstruction and perforation

Rusman

2013

BMJ Case Reports

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SUMMARYA 69-year-old cachexic man presented with tachycardia and hypotension on a background of 7 days of vomiting and constipation. He was not obviously in pain. He had a raised white cell count of 24.8×10 9 /l, and a lactate of 2.2 mmol/l. A chest x-ray had the appearance of free air under the diaphragm and he was suspected of having a bowel obstruction with perforation. An abdominal CT scan showed instead a large fluid and gas-filled hepatic abscess, and a second smaller simple cyst. The abscess was percutaneously drained, and the purulent fluid drained grew Streptococcus milleri. The patient was discharged home 2 weeks later. BACKGROUND

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Synchronous pyogenic liver abscess and acute cholecystitis: how to recognize it and what to do (emergency cholecystostomy followed by delayed laparoscopic cholecystectomy)

Abstract: A simple algorithm is presented for the selection of patients with AC to undergo a CT scan to identify synchronous PLA. Emergency CS followed by delayed LC is a viable, first-line treatment option for synchronous PLA and AC.

Cited by 9 publications

References 28 publications

First Schistosomal Cholecystitis Complicated by Cholangitis and Liver Abscess: Case Report and Review of Literature

First Schistosomal Cholecystitis Complicated by Cholangitis and Liver Abscess: Case Report and Review of Literature

Pyogenic Liver Abscess Complicating Acute Cholecystitis: Different Management Options

A liver abscess presenting as bowel obstruction and perforation

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