Liver Abscess Caused by Citrobacter Freundii Secondary to Cholecysto-antral Fistula: A Case Report

Liver abscesses secondary to bilio-enteric fistulas are rare and therefore unknown to the attending physician. In this report, we present a bilio-enteric communication, between the gallbladder; which was macro lithiasic; and the stomach revealed by an upper digestive hemorrhage in a septic context in a 34 year old man. A pyogenic bacterial liver abscess developed because of the fistula without biliary obstruction. The patient was treated surgically with disconnection of the fistula and drainage of the abscess. The liver abscess is probably due to the contamination of the bile by the cholecysto-gastric fistula. The germ isolated was a citrobacter freundii which is rarely involved in liver abscesses.