• Hee Yeon Kim and Hyo-Jin Lee.
• Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do, Republic of Korea.
• Medicine (Baltimore). 2021 Dec 3; 100 (48): e27789.

RationaleA hepatobronchial fistula and lung abscess following a pyogenic liver abscess is a rare entity and it is not easy to diagnose this condition based on the symptoms and chest radiography.Patient ConcernsAn 81-year-old man presented with productive cough and dyspnea.DiagnosisChest radiography indicated increased opacities in the right lower lung field with an air-fluid level suggestive of pneumonia complicated by a lung abscess. Chest and abdominal computed tomography revealed an abscess in the right lower lung field that bordered an abscess at segment 7 of the liver. Tubography confirmed a fistula between the liver and lung abscesses.InterventionsDue to communication between 2 abscesses, transhepatic approach was done instead of transpleural approach to avoid complications.OutcomesA liver abscess complicated by a lung abscess was resolved following percutaneous transhepatic drainage of the liver abscess and antibiotic administration.LessonsThough uncommon, the lack of suspicion of sub-diaphragmatic liver abscess often lead to a delay in diagnosis and proper treatment. Our case implies the importance of computed tomography in early diagnosis of liver abscess in case of lung abscess in the right lower lung field.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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