Abstract：
A woman in her 40s presented to hospital with cholangitis. A magnetic resonance cholangiopancreatography showed a moderately dilated common bile duct and mild intrahepatic duct dilatation with sludge. She underwent a successful endoscopic retrograde cholangiopancreatography (ERCP) and sphincteroplasty. She subsequently developed recurrence of fevers and abdominal pain with rising inflammatory markers. Initial investigations and imaging were unremarkable. A positron emission tomography scan demonstrated multiple fluorodeoxyglucose (FDG)-avid hepatic lesions, and subsequent imaging confirmed multifocal liver abscesses without a drainable collection. The patient was managed with intravenous co-amoxiclav initially before switching to oral antibiotics, however, represented 1 week later with similar symptoms. Her antibiotic coverage was broadened to intravenous pipercillin-tazobactam, and she was discharged on this with follow-up in clinic. This case report highlights the rare complication of hepatic abscesses following ERCP and the importance of considering this as a differential in patients who present with sepsis following the procedure.
摘要：
一名40多岁的妇女因胆管炎被送往医院。磁共振胰胆管造影显示胆总管中度扩张，污泥肝内胆管轻度扩张。她成功接受了内镜逆行胰胆管造影术（ERCP）和括约肌成形术。随后，她出现了发烧和腹痛的复发，炎症标志物升高。最初的调查和成像并不明显。正电子发射断层扫描扫描显示多个氟脱氧葡萄糖（FDG）狂热的肝脏病变，随后的成像证实了多灶性肝脓肿，没有可引流的集合。在改用口服抗生素之前，最初对患者进行了静脉注射联合阿莫昔卡夫治疗，然而,1周后出现类似症状。她的抗生素覆盖范围扩大到静脉注射哌立西林-他唑巴坦，她在诊所接受随访后出院了。此病例报告重点介绍了ERCP后肝脓肿的罕见并发症，以及将其视为术后败血症患者的差异的重要性。
