Hepatic abscesses after adhesiolysis. (2015)

• Record Type: Journal Article
• Authors: Antonsen, J.; Balachandran, R.; Helgstrand, F.
• Is Part Of: International journal of surgery case reports. Volume 16(2015)Supplement
• Page Start: 37
• Page End: 38
• Publication Date: 2015
• Subjects: Surgery -- Liver -- Absces -- Prophylactic antibiotics -- Case story; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2015.09.002
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Prolonged ileus can cause bacterial translocation. Development of hepatic abscesses after ileus is possible. Prophylactic antibiotics should always be considered. Abstract: Introduction: Hematogenous spread of bacteria from the bowel due to bacterial translocation has been postulated in animal and trauma studies. This case presents a patient with possible hematogenous bacterial spreading after acute laparotomy. Case presentation: A 57-year old woman was admitted with abdominal pain. A computed tomography showed mechanical small bowel obstruction. A laparotomy was performed showing no contamination, and no bowel resection was performed. The patient was not given any antibiotics during this time. The patient was re-admitted 24 h after discharge with fever, elevated white count and abdominal pain. A computed tomography showed newly developed intrahepatic abscesses. These were treated with antibiotics, and the patient was discharged with follow-up ultrasound showing diminished abscesses. Discussion: This case discusses the possible pathophysiology behind the development of intrahepatic abscesses after small bowel obstruction. Conclusion: Febrilia and pain in upper right quadrant of the abdomen days after a simple operation for bowel obstruction could be caused by translocation of intestinal bacteria and subsequent formation of hepatic abscesses.