[ Monash University ]

Museum of Pathology

CHOLANGITIC LIVER ABSCESSES

CHOLANGITIC LIVER ABSCESSES

Clinical History

A man of 69 who had previously had a cholecystectomy and a stone removed from the common bile duct, developed upper abdominal pain and jaundice. He was considered too ill for an operation and died soon after admission to hospital.

Pathology

The specimen includes a portion of liver, pancreas and extra-hepatic bile ducts. The liver has been sliced to display the cut surface and the cystic and common bile ducts have been opened. At the termination of the common bile duct there was an oval calculus, which has been lost. Proximal to this obstruction, both the intra- and extra-hepatic bile ducts are dilated. The cut surface of the liver shows several irregular subcapsular areas of necrosis and abscess formation. A few external smaller abscesses are also present. This is an example of a calculus impacted in the common bile duct and associated obstructive jaundice, and liver abscesses due to suppurative cholangitis.