M Robert1, P Paparel, E Arnal, E Voiglio, J-L Caillot. 1. Service d'urgence chirurgicale, CHLS, 69495 Pierre-Bénite et EA 37-38, Faculté de médecine Lyon Sud, 69600, Oullius, France.
Abstract
INTRODUCTION: Pyogenic liver abscess often revealed by right sided abdominal pain and fever is a serious and life-threatening pathology. Biliary tract disease is the origin of the abscess in most cases but sometimes remains unidentified. A sigmoid septic source sometimes paucisymptomatic or hidden by an immunosuppressive treatment must be looked for. EXEGESIS: Here are four observations of liver abscesses, which are secondary to unknown sigmoiditis. The etiologic diagnosis was made either by abdomino-pelvic computed tomography or by enema with water-soluble products completed by a coloscopy. Each patient's liver abscesses were emptied by aspiration or catheter drainage in conjunction with antibiotics. Surgical treatment of sigmoiditis was performed either at the same time or later. CONCLUSION: Any liver abscess of unknown origin must lead to a search for unknown or disguised septic sigmoid pathology. Most of the time, injected abdomino-pelvic computed tomography makes the diagnosis possible, but enema associated with coloscopy is sometimes necessary.
INTRODUCTION: Pyogenic liver abscess often revealed by right sided abdominal pain and fever is a serious and life-threatening pathology. Biliary tract disease is the origin of the abscess in most cases but sometimes remains unidentified. A sigmoid septic source sometimes paucisymptomatic or hidden by an immunosuppressive treatment must be looked for. EXEGESIS: Here are four observations of liver abscesses, which are secondary to unknown sigmoiditis. The etiologic diagnosis was made either by abdomino-pelvic computed tomography or by enema with water-soluble products completed by a coloscopy. Each patient's liver abscesses were emptied by aspiration or catheter drainage in conjunction with antibiotics. Surgical treatment of sigmoiditis was performed either at the same time or later. CONCLUSION: Any liver abscess of unknown origin must lead to a search for unknown or disguised septic sigmoid pathology. Most of the time, injected abdomino-pelvic computed tomography makes the diagnosis possible, but enema associated with coloscopy is sometimes necessary.