肝膿瘍に合併した右膿胸の1例

Right Pyothorax Associated with Liver Abscess：Report of a Case

はじめに　肝膿瘍に対する経皮的ドレナージは標準治療の一つであるが，われわれは肝膿瘍に対する経皮的ドレナージ施行後に発症した右膿胸を経験したので報告する．

The patient is a 66-year-old man. He came to our hospital with fever for two weeks. Based on blood sampling and abdominal computed tomography （CT） scan, a diagnosis of liver abscess was made, and antibiotic treatment was started, but symptoms did not improve, so percutaneous drainage was performed. One week later, he became dyspnea and chest CT scan revealed right pyothorax, so video-assisted thoracoscopic curettage was performed. It has been reported that liver abscesses are complicated by pyothorax in a few percent of cases. There are two hypotheses as to the mechanism. The one is the spread of inflammation from the liver abscess through the diaphragm into the pleural space, and the other is iatrogenic complication of percutaneous liver drainage.