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Journal of Case Reports
Exploring the Uncharted Territory: Hepatoduodenal fistula secondary to Amoebic Liver Abscess
Manoj Krishna Cuddapah, Dwarakanath Reddy Vembuluru, Vamsi Krishna Pothula Rajendra, Thirunavukkarasu Sampath
Department of Surgical Gastroenterology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India.
Corresponding Author:
Dr Dwarakanath Reddy Vembuluru
Email: dwarak858@gmail.com
Received: 28-OCT-2023 Accepted: 05-JAN-2024 Published Online: 15-APR-2024
DOI: http://dx.doi.org/10.17659/01.2024.0009
Background: Complications of amoebic liver abscess include rupture into various cavities such as pleural, peritoneal, and pericardial. Hepatoenteric fistula secondary to liver abscess is rare, with hepatoduodenal fistula being exceptionally uncommon. Here, we present a case report of this rare occurrence. Case Report: A 38-year-old alcoholic male presented to the outpatient department with right upper quadrant abdominal pain for the past 10 days, accompanied by fever and vomiting. Laboratory investigations revealed leucocytosis and deranged liver function tests. Radiological investigations confirmed hepatoduodenal fistula secondary to amoebic liver abscess with peritoneal rupture. The patient underwent drainage of the abscess, fistula takedown, primary suturing with tube duodenostomy, and feeding jejunostomy. Conclusion: Management of hepatoduodenal fistulas lacks clear-cut guidelines. Surgical intervention becomes necessary in cases of persistent fistula, lack of response to medical management, sepsis, and rupture into the peritoneal cavity.
Keywords : Amoebic Liver Abscess, Complications, Hepatoduodenal fistula, Hepatoenteric Fistula.
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