We report a case of
septic shock associated with
pyogenic liver abscess rescued with percutaneous transhepatic
abscess drainage (
PTAD). A 70-year-old male patient was admitted to our outpatient department of internal medicine with general
fatigue, dullness of bilateral shoulders and extremities, appetite
loss, weight loss,
headache, and
vertigo. Laboratory tests showed severe inflammatory indications,
anemia, and high values of hepatobiliary
enzymes and
blood sugar. Abdominal ultrasonography and enhanced CT showed a
pyogenic liver abscess of 10 cm in diameter at
S 6-7 in the right hepatic lobe. The patient's condition deteriorated suddenly that night. From the results of abdominal ultrasonography and enhanced CT, we made diagnosis of
septic shock associated with
pyogenic liver abscess. Emergency abdominal ultrasound-guided
PTAD was performed under
local anesthetic. Postoperatively, the
antibiotic was infused daily through a
PTAD tube into the
liver abscess space. He recovered and his laboratory tests improved gradually. On abdominal ultrasonography and enhanced CT, the
liver abscess disappeared by 19th postoperative day, and
PTAD tube was removed. There was no complication during
PTAD treatment. We conclude that patients in
septic shock should undergo further examinations immediately and treatment of the infected tissue should be started as soon as possible.
PTAD may be an additional effective procedure for
pyogenic liver abscess in
septic shock. Furthermore, local
antibiotic lavage through a
PTAD tube into the
liver abscess space may be an important supplementary method in the management of the illness.