A CASE OF ACUTE CHOLECYSTITIS COMPLICATED WITH HEPATIC ABSCESS DUE TO PENETRATION

We experienced a case of acute cholecystitis complicated with hepatic abscess due to penetration. The patient was a 54-year-old male, who consulted our department with the main complaints of abdominal pain and jaundice. Abdominal ultrasonography and CT examination showed an enlarged cholecyst and the cavity of an abscess in the contiguous liver. The results of the hematologic examination provided a suspision of preliminary conditions for DIC. Though chemotherapy was attempted, in remittent fever continued. Percutaneous drainage of the hepatic abscess under ultrasonography (PTAD) was performed at day 11 of hospitalization. Cholecystography demonstrated a communication between the abscess cavity and an inferior site of the cholecyst. At surgery, no gallstone was recognized in the cholecyst, and the fistula was unclear. In Japan, there have been only 3 reported cases of hepatic abscess due to penetration by cholecystitis, with gallstones. Therefore, this case can be said to be a rare case of cholecystitis complicated with hepatic abscess due to penetration without gallstone, which has not been reported.