Septic shock secondary to emphysematous hepatitis
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While intra-abdominal emphysematous infections involving a variety of abdominal organs have been widely recognized, few reported cases have described similar emphysematous changes occurring in the liver. Emphysematous changes in the liver have typically been seen in clinical situations involving gas-forming bacteria (e.g., liver abscesses), following sphincterotomy, bowel infarction and hepatic artery thrombosis after liver transplantation. Blachar et al. (2001) first reported a case of a 43-year-old diabetic patient who was found to have an extensive replacement of the entire liver parenchyma by air with no evidence of abscess or liver lesion. Since then, only a few case reports have discussed similar radiographic findings. Despite aggressive management, all reported cases of emphysematous hepatitis have led to fatal outcomes within 24 to 72?h of admission. We report a case of fulminant liver failure in the setting of emphysematous hepatitis and bacteremia, in a patient with a history of pancreatic cancer and liver metastasis...

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