Abstract
Amebic liver abscess is a relatively uncommon disease in Japan and an early diagnosis is not always easy. This short communication is to report a case of amebic liver abscess clinically simulating acute abdomen.
Patient is a 39-years-old Japanese male with a chief complaint of remittent fever and right lower quadrant pain for the abdomen for two days duration. Four months prior to admission, he traveled around south east Asia. Laboratory data was essentially unremarkable except leukocytosis. Antibiotics appeared to be ineffective. He was operated upon as an acute abdomen, possibly acute cholecystitis, on 9 days after admission, however no significant lesion could be found in the abdominal cavity.
Postoperatively, fever remained and right upper quadrant pain still persisted. Chest x-ray of 3 weeks postoperatively showed remarkable elevation of the right hemidiaphragm. Liver scan and computed axial tomography of the abdomen showed space-occupying lesion in the liver parenchyma of the right lobe. Although study of stool did not show cystic forms of entameba historitica, anti-amebic agent, metronidazole was started and the symptoms were immediately disappeared. Since diagnosis of liver abscess was correctly established, the abscess was drained by transcutaneous catheter, by which the abscess was finally disappeared. CT scanning and test administration of metronidazole appeared to be of diagnostic value for amebic abscess of the liver.
