Case Report

Liver Metastasis Presenting as Pneumoperitoneum

Authors: John Fondran, MD, Gary B. Williams, MD

Abstract

A 63-year-old man presented to the emergency department with sudden-onset abdominal pain. Chest radiography demonstrated pneumoperitoneum. At surgery, the source was found to be a ruptured hepatic abscess. Cultures grew Clostridium perfringens, and biopsies confirmed metastasis of a previously resected pancreatic cancer. We document this rare cause of pneumoperitoneum and briefly review the literature on liver abscess as it relates to metastatic cancer.


Key Points


* Liver abscess is a complication of metastatic cancer, which carries a high mortality rate.


* Although many liver abscesses contain anaerobic bacteria and air, rupture causing pneumoperitoneum is exceedingly rare.

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