case_images: PMC10908293_01
case_images: posterior anterior chest X-ray showing the air-fluid level below the right hemidiaphragm
case_images: PAMJ-46-107-g001.jpg
case_images: PMC10908293_01_PAMJ-46-107-g001.jpg
case_images: F1
case_images: Diagnostic assessment: chest radiograph revealed an air-fluid level under the right hemidiaphragm (Figure 1).
case_images: A,B) axial and sagittal non-contrast computed tomography scan of the abdomen showing a large gas-forming liver abscess in segments VII and VIII with peri-hepatic and intrahepatic air-fluid levels
case_images: PAMJ-46-107-g002.jpg
case_images: PMC10908293_01_PAMJ-46-107-g002.jpg
case_images: F2
case_images: Non-contrasted abdominopelvic computed tomography (CT) scan showed a large (14 x 12 x 9 cm) abscess in segments IV, VII, and VIII of the liver, intrahepatic air-fluid levels, hydropneumoperitonium but no stones in the biliary tree (Figure 2).
case_images: the area pointed by the arrow showing the abscess cavity inside the liver parenchyma that was exposed after the debridement of the necrotic roof of the liver
case_images: PAMJ-46-107-g003.jpg
case_images: PMC10908293_01_PAMJ-46-107-g003.jpg
case_images: F3
case_images: During surgery, 400 mL of bilious fluid was found in the peritoneum, a walled-off pelvic abscess with 300 mL of frank pus, walled-off right subphrenic gas, and an abscess with 800 mL of frank pus, grade 1 small bowel adhesions, and liver capsule necrosis (6 x 6 cm) in segments VII and VIII, which ruptured and drained a mixture of pus and bile from the abscess cavity (Figure 3).
case_images: demonstrating endoscopic retrograde cholangiopancreatography with spillage of contrast through the fistula (arrow)
case_images: PAMJ-46-107-g004.jpg
case_images: PMC10908293_01_PAMJ-46-107-g004.jpg
case_images: F4
case_images: No common bile duct (CBD) stones were observed (Figure 4).