Huge pyogenic liver abscess (PLA) in an elderly patient with dia-betes following the pancreaticoduodenectomy

We described an elderly female with type 2 diabetes referred to our hospital with fever, nausea and upper abdominal pain. The patient had got duodenal tumor and received the pancreaticoduodenectomy（PD）12 years ago. The laboratory examinations revealed white blood cells（WBC）increasing and severe hypocalcemia. Abdominal computed tomography（CT）revealed a huge gas-forming pyogenic liver abscess（PLA）in left lobe of the liver. The patient got cured after correction of calcium metabolism disorders, treatment with antibiotic and receiving percutaneous tube drainage. We concluded that we should remain on high alert of those patients with DM and the history of cancer, when he or she gets fever of unknown origin and abdominal tenderness. PLA should be considered.