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Hepato-Duodenal Fistula Complicating a Pyogenic Liver Abscess: An Unusual Presentation
An elderly male with type 2 diabetes mellitus was admitted to the emergency ward with fever and pain over the right hypochondrium since one month. An abdominal ultrasound revealed an ill-defined hypoechoic lesion with multiple air foci measuring 8 x 6 x 4 cm within the left lobe of the liver implica...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7819428/ https://www.ncbi.nlm.nih.gov/pubmed/33500859 http://dx.doi.org/10.7759/cureus.12236 |
Sumario: | An elderly male with type 2 diabetes mellitus was admitted to the emergency ward with fever and pain over the right hypochondrium since one month. An abdominal ultrasound revealed an ill-defined hypoechoic lesion with multiple air foci measuring 8 x 6 x 4 cm within the left lobe of the liver implicating segments III b and IV. A contrast-enhanced computed tomography (CECT) scan of the abdomen showed a similar lesion with leakage of oral contrast into the dependent areas of the collection from a rent in the antero-inferior aspect of the first part of the duodenum. Hepato-duodenal fistula or entero-hepatic fistula secondary to pyogenic liver abscess is an atypical and unusual complication requiring a high degree of suspicion for its diagnosis. Though optimal therapy for its management is still not known, early diagnosis with prompt initiation of therapy is imperative to reduce mortality. |
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