Recurrent Hepatolithiasis and Hepatic Abscess Secondary to Caroli’s Disease – Case Report

Background Hepatolithiasis is the presence of gallstones in intrahepatic ducts due to primary, idiopathic or infectious causes (lithogenic bile) secondary such as congenital cysts and strictures past hepatobiliary surgery. Typically, hepatolithiasis patients presents with Charcot’s triad (abdominal pain, jaundice, fever) suggestive cholangitis. It not uncommon for severe cholangitis be accompanied a hepatic abscess. The treatment consists supportive measures cholangitis, subsequent stone extraction surgical removal bile drainage. Patients should closely monitored because high risk recurrence, liver cirrhosis cholangiocarcinoma. Case presentation Our patient 61 years old male following medical history presentation: Right nephrectomy before approximately 15 years, polycystic renal disease. Seven ago, he underwent procedure cholecystectomy choledocho-duodenal anastomosis gallbladder CBD stones. A year later, undergoes an urgent intra-abdominal abcess (right subphrenic). For next five had no complaints. Three months prior surgery admitted hospital persistent, recurring episodes fever (38.5 °C), which did respond well antibiotic therapy. Radiology confirms stones, bilateral cystic dilations (Caroli’s Disease) abscess VII th segment. continues conservative until optimal parameters are reached eventual procedure. segment partially resected, calculi extracted hepatico-jejunostomy performed, joining Roux limb biliary confluence. Discussion Depending on current terms severity disease classification hepatolithiasis, surgeon has weigh decide upon possible options. Among them we mention treat acute pharmacologic therapy (statins), percutaneous transhepatic cholangioscopic lithotomy, peroral lithotripsy Conclusion recurrence experience chronic eventually develop over period 10 20 years. Furthermore, incidence cholangiocarcinoma about 5% 10%. These require long-term follow-up increased cancer after Keywords: General Surgery, Hepatobiliary Hepatolithiasis, Caroli’s Disease, Congenital Biliary Cysts. DOI: 10.7176/ALST/97-01 Publication date: January 31 st 2023