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Cirujano general
versão impressa ISSN 1405-0099
Resumo
SEVILLA SANTOYO, Mizael Orlando; BOLANOS BADILLO, Luis Enrique e FRIAS ALMARAZ, Julián Felipe. Hepatic abscess secondary to intrahepatic pyocholecyst perforation. Cir. gen [online]. 2023, vol.45, n.1, pp.43-46. Epub 30-Set-2023. ISSN 1405-0099. https://doi.org/10.35366/110702.
Introduction:
spontaneous gallbladder perforation is a rare complication of gallbladder pathologies, it’s seen in approximately 2% with mortality risk reported between 12-42%. If a secondary hepatic abscess is associated is even a less frequent complication.
Material and methods:
55 year old woman, who visits the emergency room referring approximately a month with abdominal pain which irradiates to the inter-scapular region. Laboratory tests reported elevated leukocytes, alkaline phosphatase and gamma glutamyl transferase. The contrasted abdominal CT showed a gallbladder with impacted biliary calculus, as well as an intrahepatic rupture of the gallbladder associated to a hepatic abscess.
Results:
a laparoscopic cholecystectomy, abscess drainage and intraabdominal drain placement was carried out. We used four laparoscopic trocars. We found a Parkland 5 gallbladder and a hepatic abscess in segments IV and V. The surgical piece was extracted with an extracting bag and 19 Fr drains were placed to Winslow hiatus and the abscess cavity.
Conclusions:
gallbladder perforation with a secondary formation of a hepatic abscess is a very rare complication. It represents a diagnostic challenge, though due to recent diagnostic tools, prompt diagnosis is a possibility.
Palavras-chave : gallbladder empyema; bilioma; gallbladder perforation; hepatic abscess; laparoscopy.