Presentation
Complicated course of small bowel obstruction. Bowel perforation status post resection and washout. Recurrence of abdominal pain.
Patient Data
Along the lateral right lobe of the liver, there is a large subcapsular fluid collection. There is a thick enhancing wall and peripheral septation.
Case Discussion
This is a case of a subcapsular abscess following a small bowel obstruction complicated by bowel perforation. The patient was brought to the operating room for bowel resection and peritoneal washout. The patient received multiple repeat CTs following the surgery. However, several weeks after the small bowel obstruction, the patient developed right flank pain which lead to the above CT. Interventional radiology was consulted, who performed an ultrasound-guided drainage of the fluid collection. Approximately 100 mL of purulent fluid was drained. Microbiologic culture was positive for two different strains of Klebsiella pneumoniae, as well as Citrobacter koseri.
Co-author:
Camille Dumas, DO
Christine Cooley, MD
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