Abstract
The case involved a 79-year-old man engaged in agriculture and forestry, who had been pointed out having an 85-mm hemangioma at the lateral segment of the left hepatic lobe when he underwent operation for gastric cancer 16 years earlier. The hemangioma showed no increasing tendency and he had been asymptomatic. This time a branch 3 cm in diameter hit him on the epigastric region during tree felling in a forest, and he began to have a high fever since several days after the injury. Despite administration of antimicrobial agents at a neighboring hospital, the high fever persisted and he was referred to our hospital. From imaging findings, we determined the most part of the hemangioma to have formed an abscess and performed percutaneous transhepatic drainage. Bacterial culture isolated penicillin-resistant E. coli, but clear route of this infection was undetermined. The drainage and other treatments decreased the fever, but the hemangioma structure was left and the abscess cavity did not diminish. Then operation (lateral segmentectomy of the left hepatic lobe) was performed. The resected liver was 155g in weigh and there was a cystic lesion covered with a fibrous capsule in the center, the inside of which was filled with pus. Histopathology demonstrated hemangioma structure and the abscess formation within the legion.
We present a case of abscess formation of a liver hemangioma which is rare, together with some consideration including operative indications.
