Hepatopulmonary Fistula Secondary to an Amebic Liver Abscess: A Case Report

Hepatopulmonary fistula (HPF) is an uncommon complication of amebic liver abscess (ALA) and is associated with high morbidity and mortality when not promptly recognized. We report a case of a 39-year-old man with no relevant medical history who initially presented with diarrhea, followed by fever, right upper quadrant pain, and cough with brownish sputum. Contrast-enhanced computed tomography (CT) revealed a large liver abscess with diaphragmatic disruption and secondary pulmonary extension. The patient was managed with video-assisted thoracoscopic surgery (VATS), including pulmonary decortication, wedge resection, diaphragmatic plication, and subdiaphragmatic drainage, in addition to targeted antibiotic therapy, achieving favorable clinical outcomes. This case underscores the importance of suspecting HPF in patients with ALA who develop atypical respiratory symptoms, highlights the value of CT as a key diagnostic tool, and emphasizes the role of a multidisciplinary approach. From an endemic setting, this report contributes valuable evidence to the international literature regarding a rare but potentially life-threatening complication.