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KMID : 1103920120180010094
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Korean Journal of Hepatology
2012 Volume.18 No. 1 p.94 ~ p.97
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A case of emphysematous hepatitis with spontaneous pneumoperitoneum in a patient with hilar cholangiocarcinoma
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Kim Jung-Ho
Jung Eul-Sik
Jeong Seok-Hoo
Kim Ju-Seung
Koo Yang-Suh
Hahm Ki-Baik
Kim Ju-Hyun
Kim Yeon-Suk
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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.
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KEYWORD
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Cholangiocarcinoma, Rupture, Hepatitis, Necrosis, Pneumoperitoneum
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