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[Laparoscopy-guided liver abscess drainage of multiple large formations]
Rune Munch Trangbæk1, Regnar Bøge Arnesen, Mikael Støckel
1Gastroenheden, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev. runemt@gmail.com.
Ugeskrift for Laeger
|January 24, 2015
Summary
A woman with multiple liver abscesses caused by Streptococcus anginosus, a bacterium with no apparent entry point, was successfully treated with surgical drainage and antibiotics. Follow-up confirmed no recurrence of the liver abscesses.
Area of Science:
- Hepatology
- Infectious Diseases
- Microbiology
Background:
- Liver abscesses are collections of pus within the liver, often caused by bacterial infections.
- Streptococcus anginosus group bacteria are increasingly recognized as a cause of pyogenic liver abscesses.
- Identifying the source of infection is crucial for effective treatment.
Observation:
- A 50-year-old female presented with abdominal pain, vomiting, fever, and diarrhea, indicative of an acute abdominal process.
- Elevated white blood cell count and liver enzymes suggested infection and hepatic involvement.
- Computed tomography (CT) scan identified 13 distinct liver abscesses.
Findings:
- Cultures identified Streptococcus anginosus as the causative pathogen.
- No identifiable portal of entry for the bacteria was found during investigations.
- Laparoscopic intervention allowed for complete preoperative drainage of all abscesses without catheter placement.
Implications:
- This case highlights the successful management of multiple, complex liver abscesses caused by Streptococcus anginosus.
- Complete surgical drainage, coupled with appropriate antibiotic therapy, can lead to favorable outcomes even in the absence of a clear source.
- Minimally invasive laparoscopic techniques may be effective for draining extensive liver abscesses, potentially reducing complications associated with indwelling drains.
