title: Ascending cholangitis as a cause of pyogenic liver abscesses complicated by a gastric submucosal abscess and fistula.
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.
authors.affiliation: First Department of Internal Medicine, Nagoya City University Medical School, Aichi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yamada
authors.forename: K
authors.initials: K
authors.lastname: Murakami
authors.forename: K
authors.initials: K
authors.lastname: Tsuchida
authors.forename: H
authors.initials: H
authors.lastname: Ohara
authors.forename: T
authors.initials: T
authors.lastname: Nakazawa
authors.forename: H
authors.initials: H
authors.lastname: Sano
authors.forename: H
authors.initials: H
authors.lastname: Ando
authors.forename: T
authors.initials: T
authors.lastname: Hashimoto
authors.forename: T
authors.initials: T
authors.lastname: Nomura
authors.forename: Y
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: M
authors.initials: M
authors.lastname: Itoh
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents; D002177:Candidiasis / Q000150:complications* / Q000175:diagnosis; D002761:Cholangitis / Q000150:complications* / Q000175:diagnosis; D016971:Citrobacter freundii / Q000302:isolation & purification; D004322:Drainage; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004756:Enterobacteriaceae Infections / Q000150:complications* / Q000175:diagnosis; D005500:Follow-Up Studies; D005747:Gastric Fistula / Q000175:diagnosis / Q000209:etiology*; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D008100:Liver Abscess / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D013272:Stomach Diseases / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents