Abstract

We present an unusual case of a pyogenic liver abscess containing gallstones caused by perforation from an inflamed gallbladder and spread of the infection into the liver. It was manifested by right upper quadrant abdominal pain, nausea, and vomiting for approximately 1 month. Ultrasound and computerized tomography demonstrated the finding however unappreciated, and the diagnosis was confirmed by laparoscopy. Open drainage and cholecystectomy were done, with good outcome. There have been very few reports in the literature of intrahepatic perforation of the gallbladder resulting in formation of hepatic abscess. The presentation, diagnosis, and management of liver abscesses, as well as the complications of acute cholecystitis are discussed.

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