Liver Abscess Management in a Complex Oncologic Case

Abstract

Liver abscesses pose a significant clinical challenge, particularly when complicated by underlying conditions such as cholangiocarcinoma. This case report describes the management of a complex, multiloculated liver abscess in a 50-year-old patient with a multifaceted medical history. A 50-year-old female with a history of cholangiocarcinoma and associated complications presented with progressive odynophagia and chest pain amidst a backdrop of multiple comorbidities, including diabetes mellitus, gastrointestinal disorders, and a complex surgical history. On admission, she exhibited tachycardia, hypertension, and laboratory findings indicative of microcytic anemia, electrolyte imbalances, and potential systemic hypoperfusion. Imaging did not reveal acute cardiopulmonary issues. Treatment for E. coli bacteremia and suspected liver abscess included antibiotics and percutaneous drainage with substantial purulent discharge. The patient’s care was further complicated by oral thrush and esophagitis managed successfully with antifungals. Palliative care was consulted. On day 34, the patient was discharged to home hospice. This case supports the use of percutaneous drainage as a frontline treatment for multiloculated liver abscesses and underscores the need for individualized treatment approaches. It also emphasizes the role of interventional radiology in managing complex intra-abdominal infections.