A case of hepatocolic fistula after percutaneous drainage for a gas-containing pyogenic liver abscess

Satoh, Hiroshi; Matsuyama, Satoru; Mashima, Hideaki; Imoto, Akihiko; Hidaka, Katsuhiko; Hisatsugu, Takeharu

doi:10.1007/bf02349288

Cited by 15 publications

(4 citation statements)

References 5 publications

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“…Although some radiologists have advocated needle aspiration rather than catheter drainage, 20 a direct comparison of the two techniques shows improved cure rate and reduction of the abscess cavity with catheter drainage. 21 Major complications have included hepatocolic fistula creation, 22 sepsis due to communication of the abscess cavity with hepatic vascular structures, 23 and death by biliary peritonitis. 7 The most common minor complication is treatment failure resulting in repeat drainage or surgery and occurring in 16 to 18.5% of cases.…”

Section: Drainage Procedures By Locationmentioning

confidence: 99%

Complications of Percutaneous Fluid Drainage

Lorenz¹,

Thomas²

2006

Semin intervent Radiol

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Percutaneous abscess drainage is one of the most common and rewarding procedures performed by interventional radiologists. Technical success is immediately apparent by aspiration of purulent contents and is nearly always achieved, with rates exceeding 90% in most literature studies. Clinical success is typical even for many abscesses colonized with multidrug-resistant organisms. In patients presenting with sepsis, this procedure offers an immediate and minimally invasive solution to a life-threatening condition, often resulting in defervescence and restoration of hemodynamic stability within 1 to 2 days. Although complications of abscess drainage are uncommon, radiologists should be able to recognize and treat all adverse sequelae discussed in this article.

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Section: Drainage Procedures By Locationmentioning

confidence: 99%

Complications of Percutaneous Fluid Drainage

Lorenz¹,

Thomas²

2006

Semin intervent Radiol

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“…[ 5 ] Despite the established safety of this procedure, several cases involving serious PCD-related complications have been reported, including hepatocolic fistula and hemobilia. [ 2 , 3 ] Hepatic rupture is frequently associated with blunt liver trauma. Other uncommon causes include obstetric diseases, coagulopathy and, rarely, peliosis hepatis.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 ] Severe complications associated with PCD are uncommon. [ 2 , 3 ] Furthermore, hepatic rupture is an uncommon but life-threatening liver injury with high mortality. Its management remains challenging because a delay in diagnosis may lead to fatal hemorrhagic shock.…”

Section: Introductionmentioning

confidence: 99%

Hepatic rupture

et al. 2018

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Rationale:Currently, percutaneous catheter drainage (PCD) is regarded as the first-line treatment modality of pyogenic liver abscess. Severe complications associated with PCD were uncommon. Hepatic rupture is an uncommon but life-threatening liver trauma with high mortality. Its management is challenging because a delay in the diagnosis may lead to fatal hemorrhagic shock. To our knowledge, PCD-associated hepatic rupture has never been reported.Patient concerns:We report herein a rare case of PCD-associated hepatic rupture. Its clinical courses and our therapeutic approaches are presented. Moreover, the clinical significance, underlying causes, and current views on severe liver trauma management will be discussed briefly.Diagnoses:A diabetic patient suffering from fever and malaise was diagnosed with a pyogenic liver abscess. PCD was performed because intravenous antibiotics were ineffective. The patient developed a liver rupture following PCD, with clinical and imaging confirmation but without further progression.Interventions:Surgical repair and vascular intervention were both inappropriate. As a result, medical treatments with supportive care were adopted and were found to be effective.Outcomes:The patient's condition improved gradually, with stabilized imaging and laboratory performance. He recovered uneventfully during follow-ups.Lessons:Hepatic rupture should be listed as an extremely rare but severe complication of PCD. Immediate suspicion and effective intervention may avoid an unfavorable consequence.

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“…U LTRASOUND-GUIDED PERCUTANEOUS catheter drainage (PCD) for pyogenic liver abscess has been accepted as a safe procedure in clinical settings, because of real-time monitoring for guiding the insertion of the needle at the target liver lesion. 1,2 Severe complications related to PCD, such as hepatic rupture, hepatocolic fistula, and upper gastrointestinal bleed, have been reported; [3][4][5] however, PCD-related delayed vascular complications are rare. Herein, we describe a rare case of internal mammary artery (IMA) injury due to ultrasound-guided PCD for liver infection, presenting with abdominal hematoma 2 days after the procedure.…”

Section: Introductionmentioning

confidence: 99%

Delayed bleeding complication due to internal mammary artery injury after ultrasound‐guided percutaneous catheter drainage for liver cyst infection

Arai

Masuda

Nakano

et al. 2020

Acute Medicine & Surgery

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Background: Ultrasound-guided percutaneous catheter drainage (PCD) is widely accepted as a primary treatment for pyogenic liver abscess. Severe PCD-related complications have been reported; however, delayed bleeding complications due to internal mammary artery injury are unknown. Case Presentation: An 84-year-old man undergoing hemodialysis owing to chronic kidney disease due to focal segmental glomerulosclerosis was admitted to our hospital for liver cyst infection. Ultrasound-guided PCD was carried out through the normal liver at the upper abdominal midline at the level of the sixth intercostal space. Two days later, an abdominal hematoma occurred at the puncture site. Contrast-enhanced computed tomography revealed extravasation of the distal right internal mammary artery, which was successfully treated with percutaneous coil embolization. Conclusion: Internal mammary artery injury should be considered as a differential diagnosis when a progressing hematoma develops after PCD.

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A case of hepatocolic fistula after percutaneous drainage for a gas-containing pyogenic liver abscess

Cited by 15 publications

References 5 publications

Complications of Percutaneous Fluid Drainage

Complications of Percutaneous Fluid Drainage

Hepatic rupture

Delayed bleeding complication due to internal mammary artery injury after ultrasound‐guided percutaneous catheter drainage for liver cyst infection

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