A SUCCESSFULLY TREATED CASE OF MULTIPLE LIVER-ABSCESSES ACCOMPANIED BY PORTAL VENOUS GAS

A case with multiple liver abscess accompanied by massive portal venou s gas is reported. A 61-yr-old male was admitted because of left lower abdominal pain, fever, and diarrhea. Abdominal x-ray examination demo nstrated multiple branching lucencies in the liver. Computed tomograph y revealed multiple liver abscesses and massive gas in the portal syst em as well as a thickened wall of the sigmoid colon. Enema study using contrast medium revealed a perforation of the sigmoid colon with dive rticulitis. The outcome was favorable after sigmoid colectomy in addit ion to intensive treatment with antibiotics. Bacteroides fragilis, whi ch produces gas (H-2 and NH3) by fermentation, was isolated not only f rom the resected specimen but also from blood samples. Although the pr esence of portal venous gas is a sign of poor prognosis in patients wi th intestinal infectious diseases, the sensitive detection of hepatic portal venous gas by computed tomography and the appropriate treatment may improve the patient's prognosis.