Unusual complication of amebic liver abscess: Hepatogastric fistula  

作　　者：Sunil V Pawar Vinay G Zanwar Pravir A Gambhire Ashok R Mohite Ajay S Choksey Pravin M Rathi Dileep S Asgaonkar 

机构地区：[1]Department of Gastroenterology,7th floor OPD building, Topiwala National Medical College and Bai Yamunabai Laxman Nair Hospital,Mumbai Central [2]Department of Medicine,1st floor College building,Topiwala National Medical College and Bai Yamunabai Laxman Nair Hospital,Mumbai Central

出　　处：《World Journal of Gastrointestinal Endoscopy》2015年第9期916-919,共4页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：Amebic liver abscess is a parasitic disease which is often encountered in tropical countries. A hepatogastric fistula secondary to an amebic liver abscess is a rare complication of this disease and there are only a handful of reported cases in literature. Here we present a case of an amebic liver abscess which was complicated with the development of a hepatogastric fistula. The patient presented with the Jaundice, pain and distension of abdomen. The Jaundice and pain improved partially after he had an episode of brownish black colored increase in frequency of stools for 5 to 6 d. Patient also had ascites and anemia. He was a chronic alcohol drinker. Esophagogastroduodenoscopy performed in view of the above findings. It showed a fistulous opening with bilious secretions along the lesser curvature of the stomach. On imaging multiple liver abscesses seen including one in sub capsular location. The patient was managed conservatively with antiamebic medications along with proton pump inhibitors. The pigtail drainage of the sub capsular abscess was done. The patient improved significantly. The repeat endoscopy performed after about two months showed reduction in fistula size. A review of the literature shows that hepatogastric fistulas can be managed conservatively with medications and drainage, endoscopically with biliary stenting or with surgical excision.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.

关 键 词：Amebic liver ABSCESS Hepatogastric FISTULA ESOPHAGOGASTRODUODENOSCOPY Entaameba HISTOLYTICA ULTRASONOGRAPHY Computed tomography 

分 类 号：R531.12[医药卫生—内科学]