A CASE OF HEPATIC ABSCESS DUE TO PENETRATED GASTRIC ULCER

Abstract

A case of hepatic abscess which was possibly caused by penetrated gastric ulcer is described.A 68-year-old man was seen at the hospital because of upper abdominal pain and fever. Abdominal ultrasonography and abdominal CT examination showed the cavity of a hepatic abscess with gas and thickening of the gastoric wall. On gastro-fiber examination a deep ulcer (A2-stage) at the gastric angle was recognized. The lesion was diagnosed as hepatic abscess due to penetration of the gastric ulcer. Against the hepatic abscess, the percutaneous transhepatic abscess drainage (PTAD) was performed. Streptococcus salivarium was detected on the bacterial culture examination of the abscess discharge. No communication of the abscess cavity into biliary tract or alimentary tract was found on the hepatic abscess cavitography.It is considered that the hepatic abscess in this case might be caused by penetrated gastric ulcer, because (1) there was a penetrated gastric ulcer; (2) there was a gas in the cavity of the abscess; and (3) Streptococcus salivarius was isolated from culture of abscess discharge. This case is very uncommon, in that there has been no case report of liver abscess of such mechanism of occurrence.