Complication of Amebic Liver Abscess: Biliary Fistula

Han Wook Chung; Song Ee Park; Hyun Jeong Park; Jae-Cheol Kwon; Hyung Joon Kim

doi:10.7180/kmj.2015.30.2.175

Journal List > Kosin Med J > v.30(2) > 1057051

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Chung, Park, Park, Kwon, and Kim: Complication of Amebic Liver Abscess: Biliary Fistula

Case Report

Kosin Medical Journal 2015;30(2):175-180.

Published online: 20 January 2015

DOI: https://doi.org/10.7180/kmj.2015.30.2.175

Complication of Amebic Liver Abscess: Biliary Fistula

Han Wook Chung^1,, Song Ee Park¹, Hyun Jeong Park², Jae-Cheol Kwon¹, Hyung Joon Kim¹

¹Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea

²Department of Radiology, College of Medicine, Chung-Ang University, Seoul, Korea

Corresponding Author: Han Wook Chung, Department of Internal Medicine, College of Medicine, Chung-Ang University, 102, Heukseok-ro, Dongjak-gu, Seoul 06973, Korea TEL: +82-2-6299-1376 Fax: +82-2-825-7571, E-mail: sswins@naver.com

Received 30 April 201517 June 2015 Accepted 19 June 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In amebic liver abscess, communication between liver abscess and intrahepatic bile ducts is an uncommon cause of bile leak. This condition can be treated surgically or endoscopically. However, these treatment modalities are related with high morbidity and mortality. A 49-year-old man was diagnosed with amebic liver abscess. Percutaneous drainage was performed due to poor medical response and for the purpose of preventing abscess rupture. Liver abscess-biliary communication was found at follow-up imaging study. He was treated successfully with medical therapy and supportive care without further interventions.

Keywords: Biliary fistula, Complication, Liver abscess, Amebic

References

1. Gall JK, Vincent AL, Greene JN, Sandin RL, Sniffen JC. Amebic liver abscess. Infect Med. 2001; 18:548–53.

2. Ralls PW, Barnes PF, Johnson MB, DeCock KM, Radin DR, Halls J. Medical treatment of hepatic amebic abscess: rare need for percutaneous drainage. Radiology. 1987; 165:805–7.

3. Sugiyama M, Atomi Y. Pyogenic hepatic abscess with biliary communication. Am J Surg. 2002; 183:205–8.

4. Kim HJ, Oh JS, Lee HM, Shin YH, Park YK, Kim JK, et al. A case of amebic colitis in a renal-transplant recipient. Korean J Med. 2009; 76:S131–4.

5. Ahn JH, Kim TH, Choo EH, Heon SH, Park JH, Lee MW. A case of amebic colitis and amebic liver abscess in HIV-infected patient. Korean J Med. 2006; 71:1170–4.

6. Knobloch J, Mannweiler E. Development and persistence of antibodies to Entamoebahistolytica in patients with amebic liver abscess. Analysis of 216 cases. Am J Trop Med Hyg. 1983; 32:727.

7. Stanley SL. Amoebiasis. Lancet. 2003; 361:1025–34.

8. Katzenstein D, Rickerson V, Braude A. New concepts of amebic liver abscess derived from hepatic imaging, serodiagnosis, and hepatic enzymes in 67 consecutive cases in San Diego. Medicine (Baltimore). 1982; 61:237–46.

9. Li E, Stanley SL. Parasitic diseases of the liver and intestines. Gastroenterol Clin North Am. 1996; 25:471–92.

10. Ibrarullah. Deepak K, Agarw AL, Sanjay S, Bhagwant R, Vinay K. Amebic liver abscess with intra-biliary rupture. HPB surgery. 1994; 7:305–10.

11. Kumar R, Sundar S, Sharma P, Sarin SK. Conservative management of liver abscess complicated by hepatogastric fistula. Dig Liver Dis. 2011; 43:752–3.

12. Sharma BC, Garg V, Reddy R. Endoscopic Management of Liver Abscess with Biliary Communication. Dig Dis Sci. 2012; 57:524–7.

13. Sandeep MS, Vaibhav SB, Sanjeev KT, Mukta BB, Pravin MR, Philip A. Endoscopic biliary drainage in patients with amebic liver abscess and biliary communication. Indian Society of Gastroenterology. 2006; 25:3.

14. Goh SJ, Cho YK, Park MG, Lee DY, Seo YW, Jang MY, et al. A Case of amebic liver abscess with hepatogastric fistula treated by endoscopic drainage. The Chonbuk University Medical Journal. 2011; 35:69–73.

15. Agarwal DK, Baijal SS, Roy S, Mittal BR, Gupta R, Choudhuri G. Percutaneous catheter drainage of amebic liver abscesses with and with out intrahepatic biliary communication: a comparative study. Eur J Radiol. 1995; 20:61–4.

16. Sersté T, Bourgeois N, Vanden Eynden F, Coppens E, Devière J, Le Moine O. Endoscopic drainage of pyogenic liver abscesses with suspected biliary origin. Am J Gastroenterol. 2007; 102:1209–15.

Fig. 1.

(A) More than 12.3cm sized multilayered enhanced single lesion in right liver. (B) Markedly decreased size of hepatic abscess (10.7 -> 5.6cm) after PCD insertion, and even smaller fluid component.

Fig. 2.

(A) Tubography showed abscess communicating with bile duct. Revealing a abscess-bile duct fistula at hospital day #22. (B) Minimally decreased size of hepatic abscess (5.6->5.4 cm) at hospital day #31.

Fig. 3.

(A) Interval decreased abscess size (5.4->4.6 cm) and fluid content. Probably remained communication between biliary tract and abscess at hospital day #53. (B) Interval more decreased size of abscess in Rt liver dome (4.6 -> 4.2cm). Probably disappeared communication between biliary tract with abscess.

Fig. 4.

No connection into bile duct or hepatic vein. Removal of PCD tube at hospital day #67.

TOOLS

Similar articles