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Unusual cause of a radiological subdiaphragmatic air-fluid level
  1. Rex Wan-Hin Hui1,
  2. Arthur Ho-Cheung Tang1,
  3. Lok-Ka Lam1,
  4. Wai-Kay Seto1,2,
  5. Siu-Yin Wong1,
  6. Man-Fung Yuen1,2
  1. 1Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
  2. 2State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong, Hong Kong
  1. Correspondence to Professor Man-Fung Yuen, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong; mfyuen{at}hku.hk

https://doi.org/10.1136/flgastro-2023-102562

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    A middle-aged man with an unremarkable medical history presented with fever for 2 weeks. He had no recent travel history. He had epigastric tenderness but was haemodynamically stable.

    Chest X-ray (CXR) showed a right-sided subdiaphragmatic air-fluid level (figure 1). Blood tests showed neutrophilia (14.6×109/L) and a cholangiohepatitic picture (bilirubin 77 umol/L; alkaline phosphatase 917 U/L; gamma-glutamyltransferase 743 U/L; alanine aminotransferase 302 U/L; aspartate aminotransferase 246 U/L). CT revealed a 16×11×9 cm lobulated gas-containing abscess involving the left lobe and segment …

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    Footnotes

    • Twitter @RexWHHui

    • Contributors RW-HH conceptualised and wrote the article. M-FY conceptualised and supervised the project. All authors provided clinical care for the patient and curated data. All authors have approved the final version of this article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests RW-HH is a trainee associate editor of Frontline Gastroenterology.

    • Provenance and peer review Not commissioned; externally peer reviewed.