cefotaxime and Bile-Duct-Neoplasms

An 80-year-old woman with hilar cholangiocarcinoma was hospitalized due to sudden-onset abdominal pain. Computed tomography revealed hepatic necrosis accompanied with emphysematous change in the superior segment of the right liver (S7/S8), implying spontaneous rupture, based on the presence of perihepatic free air. Although urgent percutaneous drainage was performed, neither pus nor fluids were drained. These findings suggest emphysematous hepatitis with a hepatic mass. Despite the application of intensive care, the patient's condition deteriorated rapidly, and she died 3 days after admission to hospital. Liver gas has been reported in some clinical diseases (e.g., liver abscess) to be caused by gas-forming organisms; however, emphysematous hepatitis simulating emphysematous pyelonephritis is very rare. The case reported here was of fatal emphysematous hepatitis in a patient with hilar cholangiocarcinoma.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Cefotaxime; Cholangiocarcinoma; Clostridium Infections; Clostridium perfringens; Emphysema; Escherichia coli; Escherichia coli Infections; Female; Hepatitis; Humans; Metronidazole; Pneumoperitoneum; Tomography, X-Ray Computed