Unusual complication of amebic liver abscess： Hepatogastricfistula

• 作者: Ajay S Choksey Ashok R Mohite Dileep S Asgaonkar. Pravin M Rathi Pravir A Gambhire Sunil V Pawar Vinay G Zanwar
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Amebic liver ABSCESS Hepatogastric FISTULA ESOPHAGOGASTRODUODENOSCOPY Entaameba HISTOLYTICA ULTRASONOGRAPHY Computed tomography
• 年，卷（期）: 2015,（9）
• 页码范围: 916-919
• 页数: 4页
• 分类号: R

摘要

Amebic liver abscess is a parasitic disease which isoften encountered in tropical countries. A hepatogastricfistula secondary to an amebic liver abscess is a rarecomplication of this disease and there are only a handfulof reported cases in literature. Here we present a caseof an amebic liver abscess which was complicated withthe development of a hepatogastric fistula. The patientpresented with the Jaundice, pain and distension ofabdomen. The Jaundice and pain improved partially afterhe had an episode of brownish black colored increasein frequency of stools for 5 to 6 d. Patient also hadascites and anemia. He was a chronic alcohol drinker.Esophagogastroduodenoscopy performed in view ofthe above findings. It showed a fistulous opening withbilious secretions along the lesser curvature of thestomach. On imaging multiple liver abscesses seenincluding one in sub capsular location. The patient wasmanaged conservatively with antiamebic medicationsalong with proton pump inhibitors. The pigtail drainageof the sub capsular abscess was done. The patientimproved significantly. The repeat endoscopy performedafter about two months showed reduction in fistulasize. A review of the literature shows that hepatogastricfistulas can be managed conservatively with medicationsand drainage, endoscopically with biliary stenting or withsurgical excision.