A PATIENT WITH DIABETUS MELLITES ASSOCIATED WITH GASCONTAINING PYOGENIC LIVER ABSCESS WHO WAS SUCCESSFULLY SAVED WITH AN EMERGENCY HEPATECTOMY

A 60-year-old man, who suffered from non-treated diabetus mellitus, admitted to the hospital because of fever and nausea. Abdominal CTscan and ultrasonography (US) revealed gas-containing liver abscess localized in the lateral segment of the liver. Systemic administration of antibiotics did not improve the condition of sepsis and DIC, and US guided percutaneous transhepatic abscess-drainage (PTAD) was unsuccessful because of multiple septa formation in the abscess cavity. Emergency lateral segmentectomy of the liver including the abscess cavity 10×9×5cm in size and a cholecystectomy were performed. After operation, the patient responded fairly well to therapies; sepsis and DIC gradually improved and blood sugar level became controllable by insulin. Emergency hepatectomy for gas-containing pyogenic liver abscess is a good indication in the case of which liver abscess difficult to be drained with PTAD due to multiple septa formation.