Percutaneous transhepatic drainage of lung abscess through a diaphragmatic fistula caused by a penetrating liver abscess

Abstract

Liver abscesses occurring just below the diaphragm can penetrate or perforate the thoracic cavity, resulting in lung abscess or pyothorax. Although surgical or percutaneous transpleural drainage is often required in such cases, the latter approach has some risks, including hemothorax and bronchopleural fistula formation when the cavity is surrounded by normal lung parenchyma. The present report describes a treatment technique of percutaneous transhepatic drainage through the diaphragmatic fistula to avoid the risks of a transpulmonary approach in a case of lung abscess caused by a penetrating liver abscess.

A case report of a lung abscess as a rare complication of a pyogenic liver abscess

“…However, this technique is difficult to approach the diaphragmatic fistula and poses a higher risk of complications. [ 7 ]…”

“…However, this technique is difficult to approach the diaphragmatic fistula and poses a higher risk of complications. [7] In summary, hepatobronchial fistula and lung abscess are rare complications of liver abscess. Clinicians should be aware of the possibility of hepatobronchial fistula in patients with a lung abscess in the right lower lung field that also borders a liver abscess.…”

“…A previous study reported that a lung abscess caused by a penetrating liver abscess was treated successfully by percutaneous transhepatic drainage through the diaphragmatic fistula. However, this technique is difficult to approach the diaphragmatic fistula and poses a higher risk of complications [7] …”