# Pyogenic liver abscess after Milligan–Morgan hemorrhoidectomy

## TL;DR

A 50-year-old man developed a rare liver infection after a common hemorrhoid surgery, with only four similar cases reported in 30 years.

## Contribution

This case highlights an extremely rare postoperative complication of pyogenic liver abscess after Milligan–Morgan hemorrhoidectomy.

## Key findings

- A liver abscess occurred as early as the second day after surgery.
- Only four similar cases were found in a 30-year PubMed review.
- The patient had no risk factors like diabetes or liver disease.

## Abstract

Milligan–Morgan(M-M) hemorrhoidectomy is regarded as the primary treatment option for patients diagnosed with grade III or IV hemorrhoids. Here, we present the case of a 50-year-old male who developed pyogenic liver abscesses as an unusual complication following M-M hemorrhoidectomy. Severe complications subsequent to hemorrhoid surgery are infrequent. A review of the PubMed database spanning the 30-year period between 1994 and 2024 yielded only four publications documenting patients who experienced liver abscesses following open hemorrhoidectomy. Furthermore, the patient exhibited symptoms of a liver abscess as early as the second day post-surgery, despite having no history of diabetes or liver disease, making this occurrence truly uncommon.