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Liver abscess after hemorrhoidectomy. Report of two cases
S R Parikh1, B Molinelli, T H Dailey
1Division of Colon and Rectal Surgery, St. Luke's-Roosevelt Hospital Center, New York, New York.
Purpose:
Pyogenic liver abscess after hemorrhoidectomy is extremely rare. Only two such cases have been previously reported; the diagnosis in each was made intraoperatively. We report two additional cases of hepatic abscess after hemorrhoidectomy, both treated nonoperatively with a successful outcome.
Methods:
The two cases were analyzed for history, presentation, laboratory data, radiologic studies, and bacteriology.
Results:
In both cases, the patients presented within one week of the hemorrhoidectomy. Treatment with broad-spectrum intravenous antibiotics was successful in achieving significant clinical improvement. The liver function test values reverted back to normal and follow-up computed tomography (CT) scans of the liver revealed marked improvement of the abscesses. Laparotomy was avoided in both of the patients.
Conclusions:
Increased awareness of this serious complication will afford earlier diagnosis. In addition, proper aerobic and anaerobic bacterial isolation techniques will allow appropriate nonoperative therapy, decreasing the high morbidity and mortality rates associated with this complication.