A Rare Case Of Ruptured Liver Abscess Manifested As Pneumoperitoneum- Case Report And The Review Of Literature

Abstract

The presence of free air within the peritoneal cavity is known as pneumoperitoneum. In 85% to 90% of cases pneumoperitoneum is due to perforated bowel of various aetiology which includes perforated peptic ulcer, typhoid, trauma, perforated tumour etc. We are reporting is a rare case of pneumoperitoneum resulting from a ruptured liver abscess in a young male with no comorbidity. A 28 year old male presented to the casualty of RL Jalappa Hospital and Research Centre with diffuse pain abdomen. Clinically it was sus-pected as peritonitis secondary to hollow viscus perforation. Erect abdomen X-Ray showed air under dia-phragm. Exploratory laparotomy was performed. On table it was found to be a case of ruptured liver abscess for which marsupialization and thorough peritoneal lavage was given. Culture of the pus from the liver ab-scess revealed Klebsiella sensitive to Piperacillin and Tazobactam, and antibiotic treatment was adminis-tered. Conclusion: Although pneumoperitoneum resulting from a ruptured liver abscess is rare, it must be kept in mind as a possible source, especially when the hollow organs are normal. Key words: Ruptured abscess, Pneumoperitoneum, Klebsiella, Erect Abdomen X-ray