Abstract
A 75-year-old man was admitted to our hospital for acute onset of fever and upper abdominal pain. Abdominal computed tomography (CT) revealed the presence of intraperitoneal free air and a 3 cm gas-containing lesion in segment S6 of the liver. He was diagnosed with acute peritonitis due to a ruptured liver abscess, necessitating emergency drainage under laparotomy. Clostridium perfringens (C. perfringes) were detected in the ascites. The postoperative course of the patient was uneventful without recurrence of liver abscess. The patient was discharged from hospital on the 27th day. Although gas-containing liver abscess caused by C. perfringens is rare, it is necessary to consider the possibility of infection by this organism in cases of gas-containing lesions in the liver, because the clinical course can be fulminant and fatal. This patient was saved because he was treated shortly after the occurrence, before the involvement of coexisting hemolysis.
