Subcapsular hepatic abscess post laparoscopic cholecystectomy

Case contributed by Assoc Prof Craig Hacking

Presentation

Day 7 post laparoscopic cholecystectomy with slow recovery. Worsening SOB and abdominal pain. Deranged LFTs.

Patient Data

Age: 85 years
Gender: Female

Airspace opacification in the right lower zone with loss of both the right heart border and right hemidiaphragm.

Right upper quadrant large lucency with an air-fluid level projected over the liver.

Note normal position of gastric bubble on the left.

Case Discussion

The patient underwent a CT scan in portal venous phase (images unfortunately not available) which confirmed a large subcapsular abscess in segments V and VI of the liver in the gallbladder fossa containing mixed-density fluid and gas.

A US-guided pigtail catheter was inserted later the same day which drained over 100 mL of purulent material. Culture grew E. coli. IV antibiotics were commenced and over 4 days the patient improved.

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Case information

rID: 73672
Published: 18th Jan 2020
Last edited: 20th Jan 2020
Inclusion in quiz mode: Included

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