A Case of Amebic Liver Abscess that Perforated into the Peritoneal Cavity.

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This paper deals with a case of amebic liver abscess perforated into the peritoneal cavity. A 37-year-old man who had contacted with unspecified number of women had general fatigue since one month earlier, and developed chill and fever 6 days earlier. At rest, severe right hypochondralgia occurred suddenly and extended to the entire abdomen. Abscess 10cm in size in the liver S7 and fluid collection in the abdominal cavity were present. Abdominal puncture revealed purulent ascites. Microscopic study disclosed amebic worms. Amebic liver abscess perforated into the abdominal cavity was diagnosed. Laparotomy was performed after percutaneous transhepatic abscess drainage (PTAD), followed by peritoneal lavage and drainage. Immediately, chemotherapy was started, with a prompt normalization of fever. The abscess smoothly decreased in size. The patient was discharged very much improved one month later. In the treatment of patients with liver abscess, it is important to hear details on their daily activities, to examine pus by simple microscopy as soon as possible, and to identify amebic worms, by entertaining the possibility of the disease. Appropriate drainage and early start of chemotherapy are therapies of choice.
日本臨床外科学会の論文