Preoperative Transcatheter Arterial Embolization for Spontaneous Rupture of Huge Amebic Liver Abscess with Massive Intraperitoneal Hemorrhage

Authors

  • Koesbandono Department of Radiology, Siloam Hospitals Lippo Village, Tangerang, Indonesia https://orcid.org/0000-0002-1653-9954
  • Raditya Utomo Department of Radiology, Faculty of Medicine at Pelita Harapan University, Tangerang, Indonesia
  • Benyamin Lukito Department of Internal Medicine, Siloam Hospitals Lippo Village, Tangerang, Indonesia
  • Jusef Treser Department of Digestive Surgery, Siloam Hospitals Lippo Village, Tangerang, Indonesia
  • Nyoman Aditya Sindunata Radiology Resident, Faculty of Medicine at Pelita Harapan University, Tangerang, Indonesia https://orcid.org/0000-0003-0890-7048

DOI:

https://doi.org/10.3941/jrcr.v17i8.4837

Keywords:

Ruptured Amebic Liver Abscess, Active Hemorrhage, Computed Tomography, Digital Subtraction Angiography, Transcatheter Arterial Embolization, Liver, Parasite

Abstract

An 18-year-old male developed a huge liver abscess with severe anemia over the course of 2 weeks. Abdominal contrast enhanced computed tomography showed ruptured huge liver abscess in the right liver lobe with signs of active hemorrhage (contrast extravasation). Serology examination confirmed amoeba as the suspected pathogen of cause. Angiography was performed followed by transcatheter arterial embolization to localize and control the hemorrhage. Embolization using a combination of polyvinyl alcohol and gelfoam successfully controlled the active hemorrhage. Exploratory laparotomy was performed to evacuate and debride the huge abscess. Metronidazole was given and showed good results. Huge liver abscess size is a predictor of conservative management failure and requires a gradual step-up intervention. The purpose of this paper is to explain the importance of imaging in detecting liver abscess and active hemorrhage along with the role of interventional radiology in this case.

18-year-old male with huge amebic liver abscess

Downloads

Published

2023-08-15

Issue

Section

Interventional Radiology