Infected Hepatic Cyst in A Patient Diagnosed by Air-fluid Level in An Abdominal Plain Film-A Case Report

由腹部直立式X光照片中氣－液平面診斷感染性肝囊腫：病例報告

洪啟聖(Ci-Sheng Hong) ； 葉文俊(Wen-Chun Yeh) ； 劉潔如(Chieh-Ju Liu) ； 張行遠(Shin-Yuan Chang) ； 宋之維(Chih-Wei Sung)

《內科學誌》 32卷1期 (2021/02) Pp. 50-55

https://doi.org/10.6314/JIMT.202102_32(1).07

摘要

Simple hepatic cyst is usually asymptomatic and requires no treatment, and its complication, such as hepatic cyst infection, can occur. This report describes a 68-year-old man with a large simple hepatic cyst at left lobe diagnosed 2 months before hospitalization in computed tomography of abdomen examination. One week before admission, he received panendoscopy which revealed esophageal candidiasis in local clinics. Before this admission, he came to our outpatient clinic and presented with intermittent and aggravated epigastric pain and 6 kgs weight loss. He gave no history of fever, chills and bowel habit change. Physical examination revealed palpable mass, tenderness and tympanic sound on percussion at epigastric region. Abdominal standing X-ray film revealed a cavitary lesion with air-fluid level. A gas-forming infected hepatic cyst was highly suspected. Routine laboratory tests were unremarkable, except C-reactive protein showed 16.22 mg/dl. Percutaneous transhepatic drainage of the cyst was made right away for further biological diagnosis and treatment. Milky yellowish fluid was obtained with fishy smelling odor. The drainage culture was Bacteroides capillosus. This is the first case report of infected hepatic cyst caused by the Bacteroides capillosus.

關鍵字

Infected hepatic cyst ； Air-fluid level ； Bacteroides capillosus

並列摘要

在臨床上，腹部超音波檢查常發現肝囊腫，然而，感染性肝囊腫相對少見，因此，我們今天報告一例68歲男性因為腹部直立式X光照片上腹區域發現氣－液平面而診斷感染性肝囊腫的病人，其症狀於放置穿皮經肝引流管後迅速改善，是第一例多毛擬桿菌感染性肝囊腫報告的個案。希望我們的診斷與治療經驗能提供各位臨床醫師參考。