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Introduction: Hepatic abscess as a manifestation of sickle cell disease is rare. To our knowledge there is no report of a large hepatic abscess in these patients, thus documentation of open abd percutaneous drainage techniques alone exist. This is the first report of the use of laparoscopic trocar in the drainage of a massive hepatic abscess in a sickle cell disease patient. Case presentation: A 25 year old Nigerian Yoruba male with sickle cell disease presented with upper abdominal pain, fever, massive hepatomegaly, neutrophilic leucocytosis and mildly deranged liver enzymes. Ultrasonographic findings were a large thin walled right hepatic lobar abscess, with an estimated volume of 1419 ml. It was nonresponsive to antibiotic therapy. It was evacuated under general anaesthesia via trocar drainage. A size 14Fr nasogastric tube was introduced through the trocar into the abscess cavity as a drain, with good recovery postoperatively.
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