A Case of Liver Abscess Probably Caused by Serious Acute Appendicitis

Abstract

A 58-year-old man who presented to our hospital because of general fatigue and fever had a palpable tumor in the right lower quadrant of abdomen and peritoneal signs. Blood analysis revealed high degree of inflammatory reaction and impaired hepatic function. Contrast-enhanced abdominal CT scan showed a swollen appendix associated with septum-like structure and a hepatic abscess 70 mm in longer diameter at the segment 5 of the liver. Emergency operation was thus performed. After the gangrenous appendix was removed, a drainage tube was placed in the hepatic abscess via percutaneous and transhepatic route under echo-guidance. A culture of the punctured fluid from the abscess yielded no microorganisms, but another culture of blood collected preoperatively yielded Fusobacterium sp. After the operation the patient was administered antibiotics and immunoglobulin preparation, and was discharged on the 32^nd postoperative day. There have been only 12 cases of suppurative hepatic abscess probably caused by acute appendicitis, including our case, in Japan. We present our case with a review of the literature.