Abstract
A 63-year-old man was admitted to our hospital for surgical operation for rectal cancer, but the operation was postponed because of an elevation of liver enzymes. The liver function tests became normal without any specific treatment, and he was discharged. A week later, however, he was readmitted with abnormal liver functions. Viral markers as well as autoantibodies in the sera were negative. He denied intake of any oral or parental medicines during routine queries, however, our detailed inquiry revealed that he had used sets of suppositories and ointments for external hemorrhoids before the 1st admission and also during interval of 1st and 2nd admissions. However, he did not use these drugs during hospital admissions. On the basis of chronological and circumstantial evidences, it may be proposed that either one or both external drugs (suppositories and ointments) were responsible for liver injuries. Notably, the exacerbation of liver injury after re-administration provides further supports for this notion.
