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| CASE REPORTS |
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| A case of emphysematous hepatitis with spontaneous
pneumoperitoneum in a patient with hilar
cholangiocarcinoma |
| Jung Ho Kim, Eul Sik Jung, Seok Hoo Jeong, Ju Seung Kim, Yang Suh Ku, Ki Baik Hahm,
Ju Hyun Kim, and Yeon Suk Kim |
Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science,
Incheon, Korea |
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Corresponding Author:
Yeon Suk Kim ,Tel: +82-32-460-3778, Fax: +82-32-460-3778, Email: drkim@gilhospital.com |
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| ABSTRACT |
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| 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. |
| Keywords: Cholangiocarcinoma; Rupture; Hepatitis; Necrosis; Pneumoperitoneum |
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