Percutaneous Drainage of a Post‐ERCP Liver Abscess: Successful Management of a Rare Complication—A Case Report

TL;DR

A rare liver abscess after ERCP was successfully treated with drainage and antibiotics, avoiding surgery.

Contribution

Demonstrates the effectiveness of percutaneous drainage for post-ERCP liver abscess as a minimally invasive alternative.

Findings

Ultrasound-guided percutaneous drainage resolved a 6-cm liver abscess caused by Enterococcus faecalis.

Targeted antibiotic therapy and drainage led to rapid recovery and no recurrence.

Structured follow-up is crucial for patients with biliary stents to prevent complications.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is an established treatment for choledocholithiasis but may rarely lead to pyogenic liver abscess (PLA). We report the case of a 72‐year‐old woman with a history of biliary stenting who presented with jaundice and cholestasis. ERCP with lithotripsy and sphincterotomy successfully cleared multiple stones, but she developed high fever and leukocytosis within 48 h. Imaging revealed a 6‐cm abscess in segment 7 of the liver. Ultrasound‐guided percutaneous catheter drainage was performed, yielding purulent material that cultured
Enterococcus faecalis
. The patient received a total of 10 days of targeted antibiotic therapy, with rapid defervescence, normalization of inflammatory markers, and ultrasound‐confirmed resolution of the abscess. She was discharged in stable condition, without recurrence. This case highlights the value of percutaneous drainage as a minimally invasive and effective management option for post‐ERCP PLA and emphasizes the importance of structured long‐term follow‐up in patients with biliary stents.

Liver abscess following ERCP is a rare complication that requires prompt recognition. This case demonstrates that ultrasound‐guided percutaneous drainage combined with antibiotics can lead to full recovery and avoid surgical intervention.

Figures