Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 21, 2006; 12(39): 6397-6400
Published online Oct 21, 2006. doi: 10.3748/wjg.v12.i39.6397
Pyogenic liver abscess after choledochoduodenostomy for biliary obstruction caused by autoimmune pancreatitis
Nobuyuki Toshikuni, Kyohei Kai, Shizo Sato, Motoko Kitano, Masayoshi Fujisawa, Hiroaki Okushin, Kazuhiko Morii, Shinjiro Takagi, Masahiro Takatani, Hirofumi Morishita, Koichi Uesaka, Shiro Yuasa
Nobuyuki Toshikuni, Motoko Kitano, Hiroaki Okushin, Kazuhiko Morii, Shinjiro Takagi, Masahiro Takatani, Hirofumi Morishita, Koichi Uesaka, Shiro Yuasa, Department of Internal Medicine, Himeji Red Cross Hospital, Himeji, Japan
Kyohei Kai, Shizo Sato, Department of Surgery, Himeji Red Cross Hospital, Himeji, Japan
Masayoshi Fujisawa, Department of Pathology, Himeji Red Cross Hospital, Himeji, Japan
Correspondence to: Dr. Nobuyuki Toshikuni, Department of Internal Medicine, Himeji Red Cross Hospital, 1-12-1 Shimoteno, Himeji 670-8540, Japan. toshikun@hrc-hp.com
Telephone: +81-79-2942251 Fax: +81-79-2964050
Received: June 24, 2006
Revised: June 28, 2006
Accepted: September 4, 2006
Published online: October 21, 2006
Abstract

A 68-year-old man underwent cholecystectomy and choledochoduodenostomy for biliary obstruction and nephrectomy for a renal tumor. Based on clinical and histopathologic findings, autoimmune pancreatitis (AIP) was diagnosed. The renal tumor was diagnosed as a renal cell cancer. Steroid therapy was started and thereafter pancreatic inflammation improved. Five years after surgery, the patient was readmitted because of pyrexia in a preshock state. A Klebsiella pneumoniae liver abscess complicated by sepsis was diagnosed. The patient recovered with percutaneous abscess drainage and administration of intravenous antibiotics. Liver abscess recurred 1 mo later but was successfully treated with antibiotics. There has been little information on long-term outcomes of patients with AIP treated with surgery. To our knowledge, this is the second case of liver abscess after surgical treatment of AIP.

Keywords: Autoimmune pancreatitis; Biliary recon-struction; Liver abscess