Abstract
Ruptures of nonamebic (pyogenic) liver abscesses into the thorax and peritoneum are very uncommon; but, hepatoduodenal and hepatocolonic fistulas are ever more rare. We report a case where ascending cholangitis was associated with pyogenic liver abscess formation and a gastric fistula. Drainage into the stomach was demonstrated by gastroduodenal endoscopy for gastric bleeding. After fistula formation, we could successfully treat the inflammation caused by infection of Citrobacter freundii and Candida albicans with intravenous infusion of both antibiotic and antifungal agents.
MeSH terms
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Aged
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Anti-Bacterial Agents
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Candidiasis / complications*
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Candidiasis / diagnosis
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Cholangitis / complications*
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Cholangitis / diagnosis
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Citrobacter freundii / isolation & purification
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Drainage
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Drug Therapy, Combination / therapeutic use
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Enterobacteriaceae Infections / complications*
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Enterobacteriaceae Infections / diagnosis
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Follow-Up Studies
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Gastric Fistula / diagnosis
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Gastric Fistula / etiology*
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Gastric Mucosa / microbiology
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Gastric Mucosa / pathology
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Gastroscopy
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Humans
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Liver Abscess / diagnosis
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Liver Abscess / etiology*
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Male
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Stomach Diseases / diagnosis
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Stomach Diseases / etiology*
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Tomography, X-Ray Computed
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Treatment Outcome