간기관지루가 합병된 화농성 간농양 1예
A Case of Pyogenic Liver Abscess Complicated by Hepatobronchial Fistula
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Hepatobronchial fistula, an anatomic communication between the liver parenchyma and the bronchial tree, is a rare condition, which usually develops as a complication of amoebiasis, hydatid cysts, and trauma. We report on a case of a pyogenic liver abscess complicated by a hepatobronchial fistula, which responded well to treatment with antibiotics and percutaneous drainage. A 36-yearold male patient presented with a two-week history of dry cough, shortness of breath, right side abdominal pain, and fever. Chest computed tomography scan showed a heterogeneously enhanced abscess measuring approximately 6 cm in the right liver dome. Percutaneous drainage was performed and antibiotics were administered against Group C Streptococcus cultured from the abscess. After nine days of therapy, repositioning of the drainage catheter was performed and the patient coughed suddenly during injection of contrast media, and communication from abscess to bronchus was discovered. While maintaining abscess drainage and antibiotic therapy, the fistula diminished gradually and disappeared completely with resolution of the liver abscess.
Abstract
Hepatobronchial fistula, an anatomic communication between the liver parenchyma and the bronchial tree, is a rare condition, which usually develops as a complication of amoebiasis, hydatid cysts, and trauma. We report on a case of a pyogenic liver abscess complicated by a hepatobronchial fistula, which responded well to treatment with antibiotics and percutaneous drainage. A 36-yearold male patient presented with a two-week history of dry cough, shortness of breath, right side abdominal pain, and fever. Chest computed tomography scan showed a heterogeneously enhanced abscess measuring approximately 6 cm in the right liver dome. Percutaneous drainage was performed and antibiotics were administered against Group C Streptococcus cultured from the abscess. After nine days of therapy, repositioning of the drainage catheter was performed and the patient coughed suddenly during injection of contrast media, and communication from abscess to bronchus was discovered. While maintaining abscess drainage and antibiotic therapy, the fistula diminished gradually and disappeared completely with resolution of the liver abscess.
참고문헌 (12)
- Han SY., "Liver abscess", Korean J Hepatol, 12(Supp 1), pp.S5~S17 (2006)
- Borrie J., "Hepatobronchial fistula caused by hydatid disease. The Dunedin experience 1952-1979", Thorax, 36, pp.25~28 (1981)
- Ibarra-Pérez C., "Thoracic complications of amebic abscess of the liver : report of 501 cases", Chest, 79, pp.672~677 (1981)
- Tak WY., "A case of transcatheter arterial embolizationinduced hepatobronchial fistula in a patient with hepatocellular carcinoma", Korean J Hepatol, 5, pp.55~58 (1999)
- Sikma MA., "A breakthrough in cryosurgery", Surg Endosc, 16, pp.870~ (2002)
- Kim JH., "A hepatobronchial fistula in a patient with cholangiocarcinoma", Korean J Med, 77(Suppl 5), pp.S1137~S1141 (2009)
- Jee MG., "A case of hepatobronchial fistula in liver abscess.", Korean J Med, 65(suppl 3), pp.S703~S706 (2003)
- Okuda K., "Spontaneous hepatobronchial communications preceding pyothorax in a patient with suspected liver abscess. A case report", Gastroenterology, 65, pp.124~129 (1973)
- Moawad F., "A "fishy" cough: hepatobronchial fistula due to a pyogenic liver abscess", N Z Med J, 119, pp.U1906~ (2006)
- Ala A., "Metallic cough and pyogenic liver abscess", Eur J Gastroenterol Hepatol, 13, pp.967~969 (2001)
- Nesper M., "Hepatobronchial fistula with percutaneous pyogenic abscess drainage of the liver", Gastrointest Radiol, 10, pp.129~131 (1985)
- Huch Böni RA., "Amebic abscess of the liver manifested by"hemoptysis" : US, CT, and MRI findings", Abdom Imaging, 20, pp.214~216 (1995)