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Case Report
Complication of Amebic Liver Abscess: Biliary Fistula
Han Wook Chung1, Song Ee Park1, Hyun Jeong Park2, Jae-Cheol Kwon1, Hyung Joon Kim1
Kosin Medical Journal 2015;30(2):175-180.
DOI: https://doi.org/10.7180/kmj.2015.30.2.175
Published online: January 20, 2015
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1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea

2Department of Radiology, College of Medicine, Chung-Ang University, Seoul, Korea

Corresponding Author: Han Wook Chung, Department of Internal Medicine, College of Medicine, Chung-Ang University, 102, Heukseok-ro, Dongjak-gu, Seoul 06973, Korea TEL: +82-2-6299-1376 Fax: +82-2-825-7571, E-mail: sswins@naver.com
• Received: April 30, 2015   • Accepted: June 19, 2015

Copyright © 2015 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • In amebic liver abscess, communication between liver abscess and intrahepatic bile ducts is an uncommon cause of bile leak. This condition can be treated surgically or endoscopically. However, these treatment modalities are related with high morbidity and mortality. A 49-year-old man was diagnosed with amebic liver abscess. Percutaneous drainage was performed due to poor medical response and for the purpose of preventing abscess rupture. Liver abscess-biliary communication was found at follow-up imaging study. He was treated successfully with medical therapy and supportive care without further interventions.
Fig. 1.
(A) More than 12.3cm sized multilayered enhanced single lesion in right liver. (B) Markedly decreased size of hepatic abscess (10.7 -> 5.6cm) after PCD insertion, and even smaller fluid component.
kmj-30-175f1.jpg
Fig. 2.
(A) Tubography showed abscess communicating with bile duct. Revealing a abscess-bile duct fistula at hospital day #22. (B) Minimally decreased size of hepatic abscess (5.6->5.4 cm) at hospital day #31.
kmj-30-175f2.jpg
Fig. 3.
(A) Interval decreased abscess size (5.4->4.6 cm) and fluid content. Probably remained communication between biliary tract and abscess at hospital day #53. (B) Interval more decreased size of abscess in Rt liver dome (4.6 -> 4.2cm). Probably disappeared communication between biliary tract with abscess.
kmj-30-175f3.jpg
Fig. 4.
No connection into bile duct or hepatic vein. Removal of PCD tube at hospital day #67.
kmj-30-175f4.jpg
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    • A case report and treatment considerations for pyogenic liver abscess with biliary fistula
      Abdirahman Ahmed Omar Alasso, Ismail Gedi Ibrahim, Ismail Ahmed Ali, Mohamed Rage Ahmed
      International Journal of Surgery Case Reports.2024; : 109343.     CrossRef

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