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Ruptured hepatic abscess: a rare cause of spontaneous pneumoperitoneum

Insights

A ruptured hepatic abscess caused spontaneous pneumoperitoneum in a 68-year-old woman. This rare case involved Streptococcus faecalis and gas-producing Klebsiella pneumoniae.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Infectious Diseases

Background:

  • Hepatic abscesses are collections of pus within the liver, often caused by bacterial infections.
  • Pneumoperitoneum, the presence of air in the abdominal cavity, typically indicates a perforated viscus.

Observation:

  • A 68-year-old woman presented with acute abdomen and radiographic evidence of pneumoperitoneum.
  • Surgical exploration revealed multiple abscesses in the left lobe of the liver, with one abscess clearly perforated.

Findings:

  • Bacteriological analysis of the abscess cavities identified Streptococcus faecalis and gas-producing Klebsiella pneumoniae.
  • The clinical presentation suggests spontaneous pneumoperitoneum secondary to a ruptured hepatic abscess.

Implications:

  • This case represents a previously unreported cause of spontaneous pneumoperitoneum.
  • Highlights the importance of considering hepatic abscess rupture in the differential diagnosis of pneumoperitoneum, even in the absence of typical risk factors.

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