https://www.journalajpr.com/index.php/AJPR <p style="text-align: justify;"><strong>Asian Journal of Pediatric Research</strong>&nbsp;<strong>(ISSN: 2582-2950)&nbsp;</strong>aims to publish&nbsp;high-quality&nbsp;papers in all aspects of&nbsp;‘Pediatric Research’. By not excluding papers based on novelty, this journal facilitates the research and wishes to publish papers as long as they are technically correct and scientifically motivated. The journal also encourages the submission of useful reports of negative results. This is a quality controlled, OPEN peer-reviewed, open-access INTERNATIONAL journal.</p> en-US [email protected] (Asian Journal of Pediatric Research) [email protected] (Asian Journal of Pediatric Research) Thu, 03 Sep 2026 13:17:12 +0000 OJS 3.3.0.21 http://blogs.law.harvard.edu/tech/rss 60 https://www.journalajpr.com/index.php/AJPR/article/view/573 <p><strong>Aims: </strong>To describe multiple presumed pyogenic liver abscesses developing shortly after appendectomy for acute appendicitis reported as uncomplicated in a child, and to highlight diagnostic uncertainty, portal venous findings, and management when drainage is considered unsafe.</p> <p><strong>Presentation of Case: </strong>A 7-year-old boy was admitted five days after appendectomy with fever, abdominal pain, and deterioration of his general condition. Haemoglobin was 3.5 g/dL, requiring red blood cell transfusion; white blood cell count was 24,800/mm³ and C-reactive protein was 261 mg/L. Ultrasonography and computed tomography showed multiple hepatic and pericholecystic collections, peritoneal effusion, hepatosplenomegaly, and portal cavernoma. Blood and ascitic fluid cultures were negative, and no abscess material was obtained for culture. After one week of a third-generation cephalosporin, an aminoglycoside, and metronidazole, fever and inflammation persisted; repeat computed tomography showed enlargement of the collections with capsular disruption. Treatment was escalated to intravenous imipenem, vancomycin, and metronidazole; heparin and enteral nutritional support were also initiated. Drainage was considered unsafe by the treating team because of concern for hepatic rupture. Intravenous antimicrobial therapy was continued for four weeks, with clinical and radiological improvement and a decrease in C-reactive protein to 60 mg/L. Portal cavernoma was already present on the initial imaging, and thrombophilia screening later showed reduced protein C activity.</p> <p><strong>Discussion: </strong>Appendicitis-associated liver abscesses are rare in children and are usually reported with perforated appendicitis or pylephlebitis. In this child, the appendicitis had been reported as uncomplicated, making the temporal association unusual. Because no abscess material was obtained, the pyogenic nature of the lesions remained presumptive. The chronology and significance of the portal cavernoma could not be established in the absence of previous imaging.</p> <p><strong>Conclusion: </strong>Persistent postoperative fever and abdominal symptoms should prompt abdominal imaging even after apparently uncomplicated appendicitis. When drainage is considered unsafe, prolonged antimicrobial therapy with close clinical and radiological monitoring may be effective in selected patients. A temporal association in a single case does not establish causality.</p> A. Lotfi, M. Sabib, H. Berani, T. Meskini, S. Ettair Copyright (c) 2026 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://www.journalajpr.com/index.php/AJPR/article/view/573 Thu, 03 Sep 2026 00:00:00 +0000