title: Percutaneous drainage of liver abscess complicated by hepato-venous fistula.
abstract: Severe systemic sepsis after percutaneous drainage of liver abscess is rare. We report two cases of hepato-venous fistulas between hepatic abscesses and hepatic/portal veins documented on abscessography during percutaneous drainage of liver abscesses, which resulted in severe sepsis and a stormy post drainage clinical course. Liver abscesses can rupture into the portal and hepatic veins causing worsening of systemic sepsis especially when they are in close proximity to each other. During percutaneous drainage, care must also be taken to avoid overinjection of the abscess, which can worsen the fistula. The ensuing sepsis is severe and requires aggressive intensive medical care and ventilatory support to tide the patient over the septic episode.
authors.affiliation: Department of General Surgery, Singapore General Hospital, Outram Road, Singapore 169608. gsucyf@sgh.com.sg
authors.forename: Y F A
authors.initials: YF
authors.lastname: Chung
authors.forename: K H
authors.initials: KH
authors.lastname: Tay
authors.forename: B
authors.initials: B
authors.lastname: Stan
authors.forename: A M M
authors.initials: AM
authors.lastname: Htoo
authors.forename: C H
authors.initials: CH
authors.lastname: Thng
authors.forename: P K H
authors.initials: PK
authors.lastname: Chow
authors.forename: L L P J
authors.initials: LL
authors.lastname: Ooi
authors.forename: T N
authors.initials: TN
authors.lastname: Lau
mesh_terms: D000368:Aged; D001658:Biliary Fistula / Q000150:complications* / Q000000981:diagnostic imaging; D002404:Catheterization / Q000379:methods; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006483:Hemorrhagic Septicemia / Q000188:drug therapy / Q000209:etiology; D006503:Hepatic Veins / Q000503:physiopathology; D006801:Humans; D007709:Klebsiella / Q000472:pathogenicity; D008100:Liver Abscess / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology; D018805:Sepsis / Q000188:drug therapy / Q000209:etiology*; D014057:Tomography, X-Ray Computed