title: Hepatocolic fistula: a rare presentation of pyogenic liver abscess.
abstract: A 58-year-old man was admitted due to a 4-month history of colicky right upper quadrant pain, intermittent fever, anorexia and weight loss. A contrast-enhanced CT scan of the abdomen showed an encapsulated, peripherally enhancing focus occupying the right liver lobe exhibiting capsular rupture and extension to the walls of the hepatic flexure. He immediately underwent emergency ultrasound-guided percutaneous catheter drainage and cultures of the purulent fluid later revealedEscherichia coliA colonoscopy was then performed which showed a pinpoint opening with draining pus at the hepatic flexure. A fistulogram confirmed a fistulous tract arising from the inferior aspect of the abscess cavity, draining into the posterosuperior aspect of the hepatic flexure. He was started on intravenous antibiotics and after 1 week of decreasing output, a repeat ultrasound showed very minimal residual fluid. The percutaneous catheter drain was then removed after 2 weeks and the patient was discharged improved.
authors.affiliation: Section of Gastroenterology, Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines.
authors.forename: Aeden Bernice G
authors.initials: AB
authors.lastname: Timbol
authors.affiliation: Section of Gastroenterology, Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines.
authors.forename: Karen Anjela M
authors.initials: KA
authors.lastname: Mondragon
authors.affiliation: Section of Gastroenterology, Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines.
authors.forename: Virgilio P
authors.initials: VP
authors.lastname: Banez
mesh_terms: D061605:Administration, Intravenous; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001658:Biliary Fistula / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy; D004927:Escherichia coli Infections / Q000175:diagnosis*; D006801:Humans; D008099:Liver; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents