Superinfection of focal liver lesions after bile duct procedures

Diagn Interv Imaging. 2012 Mar;93(3):e191-5. doi: 10.1016/j.diii.2012.01.001. Epub 2012 Feb 2.

Abstract

Objectives: Pyogenic liver abscess is a rare condition in the general population. The source of infection is most often biliary, and more rarely gastrointestinal via the portal tract, or even hematogenic. Other than in special contexts (scarring after radiofrequency ablation), focal liver lesions are not a usual risk factor for hepatic abscesses in patients with a history of bile duct procedures (sphincterotomy, biliary stenting, biliary enteric anastomosis). MATERIALS AND METHOD - RESULTS: We report four cases of focal liver lesions (two patients with benign lesions of the biliary cyst type and two other patients with lesions due to pancreatic cancer) complicated by a superinfection in patients with a history of bile duct procedures. There were no predisposing factors other than a context of cancer or diabetes.

Conclusion: Superinfection of a focal liver lesion should be considered when there is a suggestive clinical picture and a change in the appearance of the lesion in patients with a history of bile duct procedures in a context of cancer or diabetes.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery*
  • Aged
  • Biliopancreatic Diversion*
  • Chemotherapy, Adjuvant
  • Enterococcus
  • Escherichia coli Infections / diagnosis
  • Escherichia coli Infections / therapy
  • Female
  • Humans
  • Klebsiella Infections / diagnosis
  • Klebsiella Infections / therapy
  • Liver Abscess / diagnosis*
  • Liver Abscess / surgery
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / secondary
  • Liver Neoplasms / therapy
  • Male
  • Palliative Care
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy*
  • Postoperative Complications / diagnosis*
  • Streptococcal Infections / diagnosis
  • Streptococcal Infections / therapy
  • Streptococcus anginosus
  • Superinfection / diagnosis*
  • Superinfection / therapy
  • Tomography, X-Ray Computed