Nature Heals: Spontaneous Resolution of Liver Abscess through Hepato-colic Fistula.

ABSTRACT

Rupture of a liver abscess is a fairly common phenomenon in surgical practice. It is commoner in developing countries like India. Sites of rupture often predict the clinical course of the patient and affect the natural history of the disease, more common being the pleural and peritoneal cavity. Rupture into the bowel with fistulization is a rare phenomenon in liver abscess. Hepato-colic fistulae are being encountered following radiofrequency ablation for hepato cellular carcinoma. This occurring in the setting of liver abscess is highly uncommon. We report the first ever case in English literature, wherein an amoebic liver abscess was complicated by the occurrence of a hepato-colic fistula. The patient was a 48-year-old male who had a liver abscess in a background of alcoholic liver disease. On further investigation, he was found to have abnormal communication between the abscess cavity and the hepatic flexure of the colon. He was managed conservatively followed by spontaneous closure of the fistula.