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Hepatic abscesses after adhesiolysis.

J Antonsen1, R Balachandran1, F Helgstrand1

  • 1Køge Sygehus, Dept. of Surgery, Lykkebækvej 1, 4600 Køge, Denmark.

International Journal of Surgery Case Reports
|September 28, 2015
PubMed
Summary

Bacterial translocation from the bowel after surgery may cause liver abscesses. This case highlights a patient who developed intrahepatic abscesses following a laparotomy for small bowel obstruction, underscoring potential post-operative complications.

Keywords:
AbscesCase storyLiverProphylactic antibioticsSurgery

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Infectious Diseases

Background:

  • Bacterial translocation from the bowel is a proposed mechanism for hematogenous bacterial spread.
  • This phenomenon has been observed in animal and trauma studies.
  • This case explores its potential role in a patient following acute laparotomy.

Purpose of the Study:

  • To present a case of intrahepatic abscess formation after laparotomy for small bowel obstruction.
  • To discuss the possible pathophysiology of bacterial translocation leading to hepatic abscesses in this context.

Main Methods:

  • A 57-year-old woman underwent laparotomy for mechanical small bowel obstruction without intraoperative contamination or bowel resection.
  • The patient was not administered antibiotics perioperatively.
  • Post-discharge, she developed fever, elevated white blood cell count, and abdominal pain, leading to the diagnosis of intrahepatic abscesses via computed tomography.

Main Results:

  • Computed tomography revealed newly developed intrahepatic abscesses 24 hours after discharge.
  • Abscesses were successfully treated with antibiotics.
  • Follow-up ultrasound indicated diminished abscess size.

Conclusions:

  • Intestinal bacterial translocation following small bowel obstruction and subsequent laparotomy may lead to the formation of intrahepatic abscesses.
  • Fever and right upper quadrant pain after such procedures could indicate this complication.
  • This case underscores the importance of considering bacterial translocation in the differential diagnosis of post-operative hepatic abscesses.