Pyogenic liver abscess after open hemorrhoidectomy.

Area of Science:

• Gastroenterology
• Surgical Complications
• Infectious Disease

Background:

• Hemorrhoidectomy, specifically the Milligan-Morgan technique, is a standard treatment for advanced hemorrhoids (grade III-IV).
• While generally safe with low complication rates, rare adverse events can occur.

Observation:

• This case report details a 44-year-old male who developed septic shock and liver abscesses post-Milligan-Morgan hemorrhoidectomy.
• Literature review revealed limited documented cases of liver abscesses following hemorrhoidectomy, with some reported after rubber band ligation.

Findings:

• The patient required intensive care unit admission and intravenous antibiotics, ultimately recovering after 17 days.
• The pyogenic liver abscess was successfully treated with a six-week course of antibiotics.

Implications:

• Pyogenic liver abscess is a rare but severe complication of hemorrhoidectomy and rubber band ligation.
• Treatment involves antibiotics, potentially with drainage or surgery. Prophylactic antibiotics may be considered for high-risk patients.