Hepatic Abscess Following Acute Appendicitis

Division

North Florida

Hospital

Ocala Regional Medical Center

Document Type

Case Report

Publication Date

7-14-2022

Keywords

liver abscess drainage, abdominal pain in females, appendicitis, hepatic abscess, pyogenic hepatic abscess

Disciplines

Bacterial Infections and Mycoses | Emergency Medicine | Gastroenterology

Abstract

The authors present the case of a 29-year-old female diagnosed with acute appendicitis who underwent an uneventful laparoscopic appendectomy. Three weeks later, she returned to the emergency department with fevers, abdominal pain, chills, and nausea. Laboratory analysis revealed elevated liver enzymes and leukocytosis, and a computed tomography scan of the abdomen revealed a liver abscess. Interventional radiology placed an 8 French drainage catheter in the hepatic abscess and drained 40cc of purulent fluid. A culture of the abscess fluid revealed Streptococcus constellatus, Bacteroides fragilis, and Bacteroides ovatus. We believe appendicitis causes hematogenous spreading of bowel organisms along the portal vein, which is seeded to the liver.

Publisher or Conference

Cureus

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