Early-onset liver abscess after blunt liver trauma: report of a case.
A 23-year-old male patient underwent nonoperative management for his blunt liver trauma as he was hemodynamically stable without any signs of peritonitis initially after injury. A fever of 39.5 degrees C and severe right upper quadrant abdominal pain developed on the second day, and an abdominal computed tomography (CT) scan showed the formation of a gas-containing liver abscess in the traumatized liver. An emergency laparotomy revealed a foul-smelling liver abscess at the traumatized site, which was finally disclosed to be the result of a Clostridium species infection. A liver abscess is a rare complication following the nonoperative management of liver injury, and such an occurrence is even more rare within 1 day after injury. A Clostridium species infection is responsible for the fulminant progressing nature of the disease because the devitalized, ischemic liver parenchyma is ideal for such growth, and this is the first time that a such condition has been shown by CT images. Close observation with a high degree of suspicion is required for the successful treatment of such abscesses.
Hsieh
Chi-Hsun
CH
Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Kwei-shan, 333 Taoyuan, Taipei, Taiwan.
Hsu
Yu-Pao
YP
D000058:Accidental Falls; D000328:Adult; D003015:Clostridium Infections / Q000150:complications / Q000601:surgery; D006801:Humans; D008099:Liver / Q000293:injuries*; D008100:Liver Abscess / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D008297:Male; D011859:Radiography; D014949:Wounds, Nonpenetrating / Q000150:complications*