A multidisciplinary approach leads to a full recovery from a liver abscess

In late 2019, Jude Anwukah, 60, began experiencing abdominal pain and rapid weight loss, about 40 pounds in a few months. He was diagnosed with an abdominal abscess caused by a rare parasitic infection called Strongyloides. An abdominal abscess is when a pocket of infected fluid or pus is located inside the abdominal cavity, in or near the liver, pancreas, kidneys, or other nearby organs.

At first, doctors prescribed strong antibiotics. When that didn’t help multiple attempts were made to drain the abscess, which was in his liver. Yet, his health continued to decline.

“By the time Jude was referred to The Liver Institute he was showing symptoms of septic shock (infection throughout the body), a potentially fatal medical condition,” says Ashwini Metha, DO Transplant Hepatologist, Gastroenterologist on the medical staff of The Liver Institute at Methodist Dallas Medical Center.

Dr. Mehta confirmed that the previous, less invasive interventions were not working and the liver abscess was continuing to grow. She believed that immediate, surgical removal of the abscess was Jude’s best option, but would his condition allow him to make a full recovery?

Working collectively on patient care

“This was a complicated case with a critically ill patient,” explains Dr. Mehta. “But I felt confident we could quickly manage Jude’s condition. That confidence comes from how we operate as a team, bringing together knowledge from multiple clinicians to provide our patients with the best treatment options.”

The plan? Expedite the process of getting him into surgery and optimize his health until then.

Within a month of his first appointment, Jude was seen by two other specialists at The Liver Institute, Dr. Vichin Puri, MD, FACS Hepatobiliary/Pancreatic Surgeon, Transplant Surgery, and Dr. Edward Dominguez, MD, Medical Director, Organ Transplant and Infectious Disease.

Additionally, Dr. Mehta brought in a nutritionist to assess Jude’s extreme state of malnutrition, a factor that can greatly increase surgery risks.

A collaborative decision

After a thorough review, Jude’s team of doctors agreed that surgically removing the abscess was the best approach, but it was not without risks.

“It is very rare that liver abscesses need surgical intervention, but it was Jude’s only option” explains Dr. Puri. “Oftentimes, abscess removal requires more than one surgery, there is also the risk that during surgery, an infection can spread outside of the abscess. Additionally, because his abscess was so large, we were concerned there might not be enough healthy liver tissue remaining for him to regain normal liver functions.”

Within weeks, Jude was scheduled for surgery with Dr. Puri.

“His surgery went smoothly as did his recovery in the transplant ICU,” says Dr. Puri. “One thing I think is often overlooked is that surgery is not just about the surgeon. Better outcomes are seen when the entire team of hospital support staff have the right training and knowledge for speciality cases like hepatobiliary or transplant patients. That’s part of the Methodist difference.”

In the six months since his surgery, Jude has made a full recovery. Recent MRIs show his liver is in good health and no evidence of remaining abscess.

“Jude came to use for efficient management of his condition and to receive comprehensive care from a multidisciplinary team and that’s exactly what we achieved for him,” says Dr. Mehta. “He is so grateful to be living a healthy life and we are honored to have been a part of his medical journey.”