Pyogenic liver abscess after choledochoduodenostomy for biliary obstruction caused by autoimmune pancreatitis

World J Gastroenterol. 2006 Oct 21;12(39):6397-400. doi: 10.3748/wjg.v12.i39.6397.

Abstract

A 68-year-old man underwent cholecystectomy and choledochoduodenostomy for biliary obstruction and nephrectomy for a renal tumor. Based on clinical and histopathologic findings, autoimmune pancreatitis (AIP) was diagnosed. The renal tumor was diagnosed as a renal cell cancer. Steroid therapy was started and thereafter pancreatic inflammation improved. Five years after surgery, the patient was readmitted because of pyrexia in a preshock state. A Klebsiella pneumoniae liver abscess complicated by sepsis was diagnosed. The patient recovered with percutaneous abscess drainage and administration of intravenous antibiotics. Liver abscess recurred 1 mo later but was successfully treated with antibiotics. There has been little information on long-term outcomes of patients with AIP treated with surgery. To our knowledge, this is the second case of liver abscess after surgical treatment of AIP.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / pathology
  • Cholangiopancreatography, Endoscopic Retrograde
  • Choledochostomy / adverse effects*
  • Cholestasis / etiology*
  • Cholestasis / pathology
  • Cholestasis / surgery*
  • Follow-Up Studies
  • Humans
  • Klebsiella Infections / complications
  • Klebsiella Infections / pathology
  • Klebsiella pneumoniae
  • Liver Abscess, Pyogenic / drug therapy
  • Liver Abscess, Pyogenic / etiology*
  • Liver Abscess, Pyogenic / pathology
  • Male
  • Pancreatitis / complications*
  • Pancreatitis / pathology
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology
  • Postoperative Complications / pathology
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents