Hepatic rupture: A case report of a severe complication of percutaneous catheter drainage

Currently, percutaneous catheter drainage (PCD) is regarded as the first-line treatment modality of pyogenic liver abscess. Severe complications associated with PCD were uncommon. Hepatic rupture is an uncommon but life-threatening liver trauma with high mortality. Its management is challenging beca...

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Bibliographic Details
Published in:Medicine (Baltimore) 2018-01, Vol.97 (2), p.e9499-e9499
Main Authors: Zhang, Liang, Wan, DaLong, Zhang, LeLe, Xu, ShiGuo, Xie, HaiYang, Lin, ShengZhang
Format: Article
Language:English
Subjects:
Aged
Catheters
Clinical Case Report
Diabetes Complications - diagnostic imaging
Drainage - instrumentation
Humans
Liver - diagnostic imaging
Liver - injuries
Liver Abscess, Pyogenic - complications
Liver Abscess, Pyogenic - diagnostic imaging
Liver Abscess, Pyogenic - therapy
Male
Rupture - etiology
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Summary:Currently, percutaneous catheter drainage (PCD) is regarded as the first-line treatment modality of pyogenic liver abscess. Severe complications associated with PCD were uncommon. Hepatic rupture is an uncommon but life-threatening liver trauma with high mortality. Its management is challenging because a delay in the diagnosis may lead to fatal hemorrhagic shock. To our knowledge, PCD-associated hepatic rupture has never been reported. We report herein a rare case of PCD-associated hepatic rupture. Its clinical courses and our therapeutic approaches are presented. Moreover, the clinical significance, underlying causes, and current views on severe liver trauma management will be discussed briefly. A diabetic patient suffering from fever and malaise was diagnosed with a pyogenic liver abscess. PCD was performed because intravenous antibiotics were ineffective. The patient developed a liver rupture following PCD, with clinical and imaging confirmation but without further progression. Surgical repair and vascular intervention were both inappropriate. As a result, medical treatments with supportive care were adopted and were found to be effective. The patient's condition improved gradually, with stabilized imaging and laboratory performance. He recovered uneventfully during follow-ups. Hepatic rupture should be listed as an extremely rare but severe complication of PCD. Immediate suspicion and effective intervention may avoid an unfavorable consequence.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000009499