Ruptured Emphysematous Liver Abscess: An Unusual Presentation in Kochs.

Area of Science:

• Hepatology
• Infectious Diseases
• Radiology

Background:

• Gas forming liver abscess (GFLA) is a rare condition, typically associated with diabetes mellitus and presenting with high morbidity and mortality due to sepsis.
• Tuberculous liver abscesses often present asymptomatically, making diagnosis challenging.
• The co-occurrence of GFLA and tuberculous liver abscess is exceptionally rare.

Observation:

• This report details a rare case of a ruptured GFLA in a normoglycemic (non-diabetic) patient.
• The underlying pathology was identified as a tuberculous liver abscess.
• The patient presented with a ruptured abscess requiring management.

Findings:

• The ruptured GFLA with underlying tuberculous pathology was successfully managed non-surgically.
• Image-guided intervention proved effective in treating this rare clinical presentation.
• The case underscores that GFLA can occur in non-diabetic individuals and be associated with tuberculosis.

Implications:

• This case expands the understanding of GFLA etiology beyond diabetes, including infectious causes like tuberculosis.
• Image-guided intervention offers a viable, less invasive alternative to surgery for ruptured GFLA, even in complex cases.
• Highlights the importance of considering diverse etiologies for liver abscesses, particularly in atypical presentations.