title: Liver metastasis presenting as pneumoperitoneum.
abstract: A 63-year-old man presented to the emergency department with sudden-onset abdominal pain. Chest radiography demonstrated pneumoperitoneum. At surgery, the source was found to be a ruptured hepatic abscess. Cultures grew Clostridium perfringens, and biopsies confirmed metastasis of a previously resected pancreatic cancer. We document this rare cause of pneumoperitoneum and briefly review the literature on liver abscess as it relates to metastatic cancer.
authors.affiliation: Department of Surgery, Akron City Hospital, Summa Health System, Akron, OH 44309-2090, USA. fondran@yahoo.com
authors.forename: John
authors.initials: J
authors.lastname: Fondran
authors.forename: Gary B
authors.initials: GB
authors.lastname: Williams
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D000230:Adenocarcinoma / Q000473:pathology; D003016:Clostridium perfringens / Q000302:isolation & purification; D003937:Diagnosis, Differential; D005334:Fever / Q000209:etiology; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery; D008100:Liver Abscess / Q000150:complications / Q000382:microbiology / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology; D011027:Pneumoperitoneum / Q000175:diagnosis* / Q000209:etiology; D014057:Tomography, X-Ray Computed