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Multiple Pyogenic Liver Abscesses Caused by Microperforation of an Idiopathic Cecal Ulcer
Dong Han Yeom1, Ki Chang Sohn1, Min Su Chu1
1Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Korea.
Abstract:
Idiopathic cecal ulcer is a rare disease entity of unknown cause diagnosed by ruling out other known causes of cecal ulceration. The most common complication of an idiopathic cecal ulcer is bleeding; perforation, peritonitis, abscess, and stricture formation have been noted. The authors treated a 53-year-old woman who presented with fever and intermittent right upper quadrant abdominal pain. Multiple pyogenic liver abscess and a solitary cecal ulcer were diagnosed by radiologic, endoscopic, and pathologic examination, followed by laparoscopic cecectomy. After extensive study, we concluded that this patient's liver abscesses were a complication of the idiopathic cecal ulcer. Herein, we report a case of multiple pyogenic liver abscess caused by microperforation of idiopathic cecal ulcer.
Insights
Idiopathic cecal ulcer, a rare condition, can lead to serious complications. This case highlights multiple pyogenic liver abscesses as a potential complication from a microperforation of an idiopathic cecal ulcer.
Area of Science:
- Gastroenterology
- Hepatology
- Surgical Pathology
Background:
- Idiopathic cecal ulcer is a rare gastrointestinal diagnosis of exclusion.
- Common complications include bleeding, perforation, and abscess formation.
- Liver abscesses are typically associated with intra-abdominal infections or biliary tract disease.
Observation:
- A 53-year-old woman presented with fever and right upper quadrant abdominal pain.
- Radiologic, endoscopic, and pathologic examinations revealed multiple pyogenic liver abscesses and a solitary cecal ulcer.
- Laparoscopic cecectomy was performed.
Findings:
- The patient's liver abscesses were determined to be a complication of the idiopathic cecal ulcer.
- Microperforation of the idiopathic cecal ulcer was identified as the likely source of infection.
- This represents a rare presentation of hepatic abscesses secondary to a cecal ulcer.
Implications:
- This case expands the known spectrum of complications associated with idiopathic cecal ulcer.
- It underscores the importance of considering unusual sources of intra-abdominal infection.
- Early recognition and surgical management are crucial for favorable outcomes in such rare cases.
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