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Liver abscesses after peritoneal venous shunt.
Hideto Kawaratani1, Tatsuhiro Tsujimoto, Takuya Kubo
1Third Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
Case Reports in Gastroenterology
|July 23, 2013
Summary
A cirrhotic patient with a Denver shunt developed recurrent liver abscesses. Prompt antibiotic treatment and selective intestinal decontamination successfully resolved the infection, preventing recurrence.
Area of Science:
- Hepatology
- Infectious Diseases
- Medical Devices
Background:
- A 70-year-old male with alcoholic liver cirrhosis and diabetes mellitus presented with recurrent high-grade fever.
- The patient had a history of refractory ascites managed with a Denver shunt implantation nine months prior.
Observation:
- Initial presentation revealed elevated C-reactive protein, liver dysfunction, and multiple small liver abscesses in the right lobe.
- Despite initial antibiotic treatment, the patient experienced a recurrence of liver abscesses in both lobes.
Findings:
- Blood cultures were negative for the causative bacteria of the liver abscesses.
- Successful treatment involved prolonged antibiotic therapy followed by selective intestinal decontamination with kanamycin.
- The patient remained recurrence-free for over a year post-treatment.
Implications:
- This case highlights the potential risk of liver abscesses in cirrhotic patients with Denver shunts.
- Clinicians should consider liver abscesses in patients with fever and liver dysfunction post-shunt placement.
- This is the first reported instance of liver abscess associated with a Denver shunt in a cirrhotic patient.
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