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Choi, Kim, Kang, Kim, Choi, Kim, Lee, and Ko: Liver Abscess Secondary to Perforation after Duodenal Endoscopic Resection
Case Report

The Korean Journal of Gastroenterology 2018; 71(5): 286-289.

Published online: 25 May 2018

DOI: https://doi.org/10.4166/kjg.2018.71.5.286

Liver Abscess Secondary to Perforation after Duodenal Endoscopic Resection

Seung Ho Choi1, Su Jin Kim1, 2, Dae Hwan Kang1, 2, Hyung Wook Kim1, 2, Cheol Woong Choi1, 2, Tae Un Kim2, 3, Jeong Seok Lee1, Ji Hwan Ko1

1Division of Gastroenterology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

2Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

3Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

Correspondence to: Su Jin Kim, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea. Tel: +82-55-360-1535, Fax: +82-55-360-1536, endoksj@gmail.com

Received 25 January 2018       Revised 6 March 2018       Accepted 6 March 2018

Copyright © 2018. Korean Society of Gastroenterology

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Duodenal perforation is a complication of endoscopic mucosal resection. Liver abscess secondary to iatrogenic perforation is extremely rare. A 43-year-old female visited the hospital to remove a sub-epithelial tumor on the duodenal bulb. After endoscopic mucosal resection with band ligation, duodenal perforation occurred. Endoscopic closure was performed successfully using a clipping device to manage duodenal perforation. After 4 weeks, the patient visited our outpatient clinic due to abdominal pain and fever. Abdominal computed tomography showed liver abscess that involved segment three. Liver abscess was resolved with a 10-week antibiotic treatment. To the best of our knowledge, no case of liver abscess secondary to duodenal perforation by endoscopic resection was reported to date in Korea. Here, we report a case of liver abscess caused by a duodenal perforation after endoscopic mucosal resection.

Keywords: Duodenum, Intestinal perforation, Endoscopic mucosal resection, Liver abscess

Figures and Tables

Fig. 1

(A) Yellowish sub-epithelial tumor with a size of about 0.5 cm with biopsy-induced erosion on the top of the lesion on the duodenal bulb. (B) Occurrence of perforation at the lateral resection margin (arrows) after endoscopic mucosal resection with band ligation. (C) Successful closure of perforation with endoscopic clips.

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Fig. 2

(A) Abdominal X-ray after endoscopic resection showing bilateral sub-diaphragmatic free air. (B) Abdominal computed tomography scan showing the presence of pneumoperitoneum and clips in the duodenal bulb.

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Fig. 3

(A) Liver abscess with a size of 7.5×7.0 cm is observed in the segment three on the abdominal computed tomography. (B) Disappearance of liver abscess on a follow-up study after antibiotic treatment.

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Notes

Financial support None.

Conflict of interest None.

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