Related Experiment Video
Updated: Oct 28, 2025
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
When hiccups mean something more than just a nuisance: A rare presentation of pyogenic liver abscess
Muaaz Masood1, Pearl Uy2, John E Yap2
1Department of Internal Medicine Medical College of Georgia at Augusta University Augusta Georgia USA.
Abstract:
Pyogenic liver abscess (PLA) is an uncommon yet potentially fatal disease. The disease most commonly arises from biliary infection but may also result from hematogenous seeding and portal spread secondary to bowel contamination, direct seeding, or penetrating trauma. The diagnosis is suspected when there is a hepatic lesion on imaging. Confirmation of diagnosis requires purulent aspirate or bacterial growth on Gram stain/culture of the abscess or blood. The mainstay of treatment is antimicrobials in conjunction with either percutaneous abscess drainage or aspiration. Surgical drainage is reserved for cases of ruptured abscess, peritonitis, or in the presence of an underlying surgical cause. PLA typically presents with fever and abdominal symptoms. We report a case of an unusual manifestation of PLA, presenting as hiccups, which led to a significant delay in the diagnosis and treatment.
Insights
Pyogenic liver abscess (PLA) is a serious infection. This case highlights an unusual presentation of PLA as persistent hiccups, delaying diagnosis and treatment.
Area of Science:
- Hepatology
- Infectious Diseases
Background:
- Pyogenic liver abscess (PLA) is a rare but life-threatening condition.
- Commonly caused by biliary infections, it can also arise from other sources like portal spread or trauma.
- Diagnosis relies on imaging and confirmation via abscess aspirate or positive cultures.
Observation:
- PLA typically presents with fever and abdominal pain.
- This report details an atypical case where hiccups were the primary presenting symptom.
- This unusual manifestation led to a significant delay in diagnosis and treatment initiation.
Findings:
- The case underscores that PLA can present with non-specific symptoms like hiccups.
- Prompt recognition of atypical presentations is crucial for timely intervention.
- Standard diagnostic criteria may be challenged by unusual clinical manifestations.
Implications:
- Clinicians should consider PLA in the differential diagnosis of persistent hiccups, even without typical symptoms.
- Raising awareness of unusual PLA presentations can improve patient outcomes.
- Further research into atypical presentations may refine diagnostic and treatment protocols for PLA.
Related Concept Videos
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:23Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
01:27Acute Pyelonephritis I: Introduction
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:30Acute Pancreatitis II: Clinical Manifestations and Management