Diagnosis And Treatment Of Intrahepatic Cholangiocarcinoma Patients Masquerading As Liver Abscess

Objective To analyse the clinical features of abscesses like ICC and causes of misdiagnosis.To improve early diagnosis and guide treatment of these patients.Methods 11 cases of ICC misdiagnosed as pyogenic liver abscess(PLA) from other hospitals but proved as ICC in our hospital from January 2013 to January 2016 were analyzed retrospectively.Statistical analysis of clinical data were done with non-abscesses like ICC group and abscess group.Results 11 patients had obvious infection symptoms, complicated with bil e duct calculi in 4 cases(36.4%), combined hyperglycemia in 5 cases(45.5%). Abscesses like ICC patients easily showed abdominal pain, high white b lood cells, high percentage of neutrophils, low hemoglobin, high CA-199(P <0.05). Common imagings like ultrasound, CT and MRI had limitations in the dignosis of abscess-like ICC. The anti-infection treatment was ineffective in 11 patients, and 6 cases underwent liver biopsy and cancer cells were fo und in 4 cases(66.7%). 8 patients underwent surgery to removal tumor,and p ostoperative infection symptoms disappeared,and pathological digosis was in trahepatic cholangiocarcinoma in all patients.Until January 2016, overall s urvival were 6 months to 28 months and 3 patients wihtout surgery were all dead within 2 months.Conclusion We should take into account the possibility of intrahepatic cholangiocarcinoma with infection when the anti-infection treatment was ineffective for patients with initial diagnosis of liver abscess without liquefaction,and undergo liver biopsy when necessary and try for a early surgical treatment.