Pyogenic hepatic abscess presenting years after a choledochojejunostomy: A rare clinical occurrence

Megan Yu, Abhishek Mangaonkar, Candace Lovelace, Michael Ibe

Research output: Contribution to journalArticle

Abstract

A 69-year-old Caucasian man presented with fever, chills/rigors and night sweats since 6 days. Blood cultures (4/4) initially reported Gram negative lactose-fermenting rods. Physical examination was fairly benign which included a normal abdominal examination. Laboratory tests were significant for an elevated white cell count, erythrocyte sedimentation rate and C reactive protein . Empirically, he was treated with piperacillin tazobactam. A chart review showed that he had undergone a choledochojejunostomy for a pancreatic head tumour 7 years before. We found a few reported cases of hepatic abscesses after choledochojejunostomy presenting years after the procedure. An abdominal CT scan con firmed our suspicion. Percutaneous drainage was performed and his antibiotics were switched to ciprofloxacin and metronidazole, based on the sensitivity report. The patient's clinical condition steadily improved.

Original languageEnglish (US)
JournalBMJ Case Reports
DOIs
StatePublished - Jun 9 2014

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Pyogenic Liver Abscess
Choledochostomy
Chills
Liver Abscess
Sweat
Blood Sedimentation
Metronidazole
Lactose
Ciprofloxacin
C-Reactive Protein
Physical Examination
Drainage
Fever
Cell Count
Anti-Bacterial Agents
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pyogenic hepatic abscess presenting years after a choledochojejunostomy : A rare clinical occurrence. / Yu, Megan; Mangaonkar, Abhishek; Lovelace, Candace; Ibe, Michael.

In: BMJ Case Reports, 09.06.2014.

Research output: Contribution to journalArticle

Yu, Megan ; Mangaonkar, Abhishek ; Lovelace, Candace ; Ibe, Michael. / Pyogenic hepatic abscess presenting years after a choledochojejunostomy : A rare clinical occurrence. In: BMJ Case Reports. 2014.
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