Gas-containing pyogenic liver abscess--a case report and review of the literature.

The incidence of gas-containing pyogenic liver abscess is exceedingly rare. We report herein, a case of a 36-year-old Japanese woman with a gas-containing pyogenic liver abscess associated with diabetes mellitus and cholelithiasis. An abdominal plain X-ray film, which showed a fine air-fluid level in the liver at an up-right position, enabled us to easily diagnosed a gas-containing liver abscess. Echo-guide percutaneous drainage revealed the organism to be Escherichia coli, however, although this treatment has recently been employed often in the treatment of pyogenic liver abscesses, especially single abscesses, it did not prove effective in this case. We finally cured the gas-containing pyogenic liver abscess by operative drainage.