Korean J Gastroenterol.  2010 Aug;56(2):109-112. 10.4166/kjg.2010.56.2.109.

A Case of Subcapsular Liver Abscess Secondary to Perforating Ulcer of Gastric Cancer

• Kim DH
• Lee CH
• Jung HG

• KMID: 1775866
• DOI: http://doi.org/10.4166/kjg.2010.56.2.109

Abstract

Intrahepatic abscess is an unusual complication of peptic ulcer disease. We present a case of gastric cancer in which the ulcer penetrated into the left lobe of liver with subsequent abscess and fistula formation. Esophagogastroduodenoscopy confirmed ulcers and a fistula opening in the antrum. Abdominal computed tomogram showed a subcapsular liver abscess adjacent to the gastric antrum. Subtotal gastrectomy with curettage of the fistulous tract was performed. The final diagnosis was the signet ring cell gastric carcinoma complicating subcapsular liver abscess. To our knowledge, this is the first reported case in Korea.

Keyword

Liver abscess; Peptic ulcer perforation; Gastric cancer

MeSH Terms

Endoscopy, Gastrointestinal
Female
Humans
Klebsiella pneumoniae/isolation & purification
Liver Abscess/diagnosis/*etiology/microbiology
Middle Aged
Peptic Ulcer Perforation/*complications/diagnosis
Stomach Neoplasms/complications/*diagnosis/surgery
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. Initial abdominal CT scan showed a subcapsular liver abscess in the left lobe. Note that there was no evidence of free air.

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  Fig. 2. Endoscopic findings. (A) Air bubbles were leaking in the antral wall during the initial endoscopy. (B) During the follow-up examination, a fistula opening within the ulcer base was noticed. Note that there was pus around the orifice.

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  Fig. 3. Gross findings. (A) Two ulcers in the lesser curvature were noticed on the antral wall of the resected stomach. (B) On the cross section, perforation was noted within the thickened antral wall.

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  Fig. 4. Histologically lots of signet ring cells were observed in the antral wall (H&E, ×400).

Reference

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