Pyogenic liver abscess after choledochoduodenostomy for biliary obstruction caused by autoimmune pancreatitis.
A 68-year-old man underwent cholecystectomy and choledochoduodenostomy for biliary obstruction and nephrectomy for a renal tumor. Based on clinical and histopathologic findings, autoimmune pancreatitis (AIP) was diagnosed. The renal tumor was diagnosed as a renal cell cancer. Steroid therapy was started and thereafter pancreatic inflammation improved. Five years after surgery, the patient was readmitted because of pyrexia in a preshock state. A Klebsiella pneumoniae liver abscess complicated by sepsis was diagnosed. The patient recovered with percutaneous abscess drainage and administration of intravenous antibiotics. Liver abscess recurred 1 mo later but was successfully treated with antibiotics. There has been little information on long-term outcomes of patients with AIP treated with surgery. To our knowledge, this is the second case of liver abscess after surgical treatment of AIP.
Toshikuni
Nobuyuki
N
Department of Internal Medicine, Himeji Red Cross Hospital, 1-12-1 Shimoteno, Himeji 670-8540, Japan. toshikun@hrc-hp.com
Kai
Kyohei
K
Sato
Shizo
S
Kitano
Motoko
M
Fujisawa
Masayoshi
M
Okushin
Hiroaki
H
Morii
Kazuhiko
K
Takagi
Shinjiro
S
Takatani
Masahiro
M
Morishita
Hirofumi
H
Uesaka
Koichi
K
Yuasa
Shiro
S
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000150:complications* / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002768:Choledochostomy / Q000009:adverse effects*; D002779:Cholestasis / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications / Q000473:pathology; D007711:Klebsiella pneumoniae; D046290:Liver Abscess, Pyogenic / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D008297:Male; D010195:Pancreatitis / Q000150:complications* / Q000473:pathology; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents