Abstract
We report a case of multiple liver abscesses caused by hematogenous infection from the “broken” mucosal barrier associated with advanced gastric cancer.
A 68-year-old man, who was found having a type 3 tumor 5 cm in diameter in the lower body of the stomach, was admitted to the hospital for the purpose of operation. He had no high fever. A barium enema examination revealed no abnormal findings. There were no findings suggestive of metastasis to the liver and liver abscess. He developed a high fever of 39°C on and after the second hospital day. Blood test revealed that he developed severe inflammatory response and antibiotics therapy was started. An abdominal CT scan showed multiple target signs in the liver. A gram-negative bacillus was isolated by blood culture. Based on those results, liver abscess was diagnosed. The inflammatory response and findings of liver abscess on abdominal CT scans gradually improved due to administration of antibiotics. After the inflammatory response abated and findings of liver abscess on imaging diagnosis disappeared, total gastrectomy, distal pancreatectomy, splenectomy, cholecystectomy, surgical removal of the ileocecal tumor and D2 lymph node dissection were performed. He has been free from recurrence of hepatic abscess or gastric cancer, as of 42 months after the operation.
