A Case of Subcapsular Liver Abscess Secondary to Perforating Ulcer of Gastric Cancer

Do Hyeong Kim; Chang Hun Lee; Hyun Gwang Jung

doi:10.4166/kjg.2010.56.2.109

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Kim, Lee, and Jung: A Case of Subcapsular Liver Abscess Secondary to Perforating Ulcer of Gastric Cancer

Original Article

Korean J Gastroenterol 2010;56(2):109-112.

Published online: 21 February 2010

DOI: https://doi.org/10.4166/kjg.2010.56.2.109

A Case of Subcapsular Liver Abscess Secondary to Perforating Ulcer of Gastric Cancer

Do Hyeong Kim, M.D., Chang Hun Lee, M.D., Hyun Gwang Jung, M.D.

Division of Gastroenterology, Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea

Correspondence to: Hyun Gwang Jung, M.D. Department of Internal Medicine, Wallace Memorial Baptist Hospital, 374-75, Namsan-dong, Geumjung-gu, Busan 609- 728, Korea Tel: +82-51-580-2000, Fax: +82-51-583-7114 E-mail: anti217@paran.com

Received 13 November 2009 Accepted 1 February 2010

Abstract

Intrahepatic abscess is an unusual complication of peptic ulcer disease. We present a case of gastric cancer in which the ulcer penetrated into the left lobe of liver with subsequent abscess and fistula formation. Esophagogastroduodenoscopy confirmed ulcers and a fistula opening in the antrum. Abdominal computed tomo-gram showed a subcapsular liver abscess adjacent to the gastric antrum. Subtotal gastrectomy with curettage of the fistulous tract was performed. The final diagnosis was the signet ring cell gastric carcinoma complicating subcapsular liver abscess. To our knowledge, this is the first reported case in Korea.

Keywords: Liver abscess, Peptic ulcer perforation, Gastric cancer

REFERENCES

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2. Allard JC, Kuligowska E. Percutaneous treatment of an intrahepatic abscess caused by a penetrating duodenal ulcer. J Clin Gastroenterol. 1987; 9:603–606.

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Fig. 1.

Initial abdominal CT scan showed a subcapsular liver abscess in the left lobe. Note that there was no evidence of free air.

Fig. 2.

Endoscopic findings. (A) Air bubbles were leaking in the antral wall during the initial endoscopy. (B) During the follow-up examination, a fistula opening within the ulcer base was noticed. Note that there was pus around the orifice.

Fig. 3.

Gross findings. (A) Two ulcers in the lesser curvature were noticed on the antral wall of the resected stomach. (B) On the cross section, perforation was noted within the thickened antral wall.

Fig. 4.

Histologically lots of signet ring cells were observed in the antral wall (H&E, ×400).

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