A Case of Advanced Gastric Cancer was Discovered on Survey of Liver Abscess

Kimikyoshi Shimanuki, Michio Miyata, Keizi Bandai, Shigeki Yamada*

Department of Surgery and Pathology*, Omiya Medical Center, Jichi Medical School

We report a case of liver abscess associated with advanced carcinoma of the stomach. A 60-year-old man, who had received a cholecystectomy 21 years earlier, was admitted with high fever and abdominal pain. A abdominal computed tomography and an ultrasonography revealed a low density and low echoic multilocular cystic mass in the left lobe of the liver. Percutaneous drainage was performed and a roentgenogram after injection of contrast medium through a drainage tube revealed communication between the liver abscess and the stomach. Upper gastrointestinal barium contrast radiography and gastric fiberscopy revealed advanced gastric cancer. In order to rule out a hepatic malignant lesion, epatic angiography and endoscopic retrograde cholangiopancreatography were performed. There were no findings of malignant liver tumors. Total gastrectomy and left lateral segmentectomy of the liver were performed. Histological examination revealed direct invasion of the liver surface and no intrahepatic malignant lesion of the resected liver. The liver abscess might have been caused by direct invasion of the gastric cancer and an inflammatory process induced by penetration of the gastric wall.

Key words
liver abscess, gastric cancer

Reprint requests
Kimiyoshi Shimanuki Department of Surgery, Omiya Medical Center, Jichi Medical School
1-847 Amanumacho, Omiya, 330 JAPAN

Accepted
July 6, 1992

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