복강 내 유리기체 형태로 발견된 간 농양 파열
Spontaneous Pneumoperitoneum Secondary to the Rupture of a Gas-Containing Pyogenic Liver Abscess
김희정, 장혁재, 조용필, 김용호, 정승문, 안재홍, 한명식,
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김희정 ( )
울산대학교 의과대학 서울아산병원 외과
장혁재 ( )
강릉아산병원 외과
조용필 ( )
강릉아산병원 외과
김용호 ( )
강릉아산병원 외과
정승문 ( )
강릉아산병원 방사선과
안재홍 ( )
강릉아산병원 방사선과
한명식 ( )
강릉아산병원 외과
KMID : 0371320040660010060
Abstract
Herein, a rare case of a spontaneous rupture of a liver abscess, resulting in pneumoperitoneum, is reported. A 71-year old female with uncontrolled diabetes mellitus, developed an acute abdomen. The chest X-ray and plain abdominal radiography findings revealed bilateral subphrenic free air, and the computed tomography suggested the rupture of a gas-containing pyogenic liver abscess in the left hepatic obe, extending to the lesser omentum. An emergency laparotomy was performed, there was a ruptured pyogenic liver abscess in the left lobe, but no perforation of the hallow viscus organ. A left lobectomy of the liver, with surgical drainage, was performed. The occurrence of pneumoperitoneum secondary to the intraperitoneal rupture of a pygenic liver abscess, is extremely rare. The condition is associated with high mortality as they are often misdiagnosis at a late stage as a hollow viscus perforation. Recently advances in computed tomography and ultrasound have resulted in liver abscesses being detect earlier. It must be born in mind that a rupture of a gas-containing liver abscess can also mimic a perforation of the gastrointestinal tract.
키워드
화농성 간농양의 파열;기복강;Rupture of a gas-containing pyogenic liver abscess;Pneumoperitoneum
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