# Pyogenic Hepatic Abscess as a Complication of Appendicitis: A Case Report

## TL;DR

A rare case of liver abscess caused by appendicitis in a child is reported, highlighting the importance of early imaging and multidisciplinary care for timely treatment.

## Contribution

This case report adds to the limited literature on pyogenic liver abscess as a complication of appendicitis in children.

## Key findings

- An 11-year-old boy presented with fever and neurological symptoms, later diagnosed with pyogenic liver abscess and appendicitis.
- Multidisciplinary care including drainage and appendectomy led to successful treatment and discharge.
- Early imaging and broad differential diagnosis are crucial in pediatric septic shock cases.

## Abstract

Pyogenic liver abscess is a rare and under‐recognized complication of gangrenous or perforated appendicitis in children. Management typically requires a combination of antibiotic therapy and abscess drainage. Although uncommon in the pediatric population, pyogenic liver abscess is more frequently observed in the elderly people. With an aging population, it is increasingly important for young physicians to recognize its clinical presentation and treatment strategies. This report describes an 11‐year‐old boy admitted with fever, impaired consciousness, nausea, and vomiting—initially raising concern for meningitis. A CT scan revealed a hepatic abscess and findings consistent with acute appendicitis. Following multidisciplinary consultation, the patient underwent percutaneous drainage of the liver abscess and an appendectomy. His postoperative course was uneventful, and he was discharged with a liver drain in place. Given the limited reliability of history and physical examination in pediatric patients with septic shock—especially in emergency settings—clinicians must maintain a broad differential diagnosis.

In children with septic shock or atypical presentations, pyogenic liver abscess should be considered as a rare complication of appendicitis. Early imaging and prompt multidisciplinary management, including abscess drainage and targeted antibiotic therapy, are essential for accurate diagnosis, effective treatment, and favorable clinical outcomes.

Pyogenic liver abscess management.