Liver abscess after percutaneous ethanol injection (PEI) therapy for hepatocellular carcinoma. A case report

We present a case of liver abscess after percutaneous ethanol injection (PEI) therapy for the treatment of recurrent hepatocellular carcinoma (HCC). The 56-year-old woman had a past history of cholecystoduodenostomy for cogenital dilatation of the bile duct, and pneumobilia was observed in the intrahepatic bile ducts prior to PEI. The abscess was successfully treated by percutaneous abscess drainage and antibiotic therapy. Klebsiella pneumonia, one of the most common causative organisms of biliary tract infection, was isolated from the abscess. Thus, biliary tract infection related to the previous biliary-enteric anastomosis operation may have been one of the causative factors in the liver abscess in this patient. The rare experience reported here suggests that a careful search for coexistent abscess at the time of PEI is important in HCC patients with biliary-enteric anastomosis, especially in those with pneumobilia.