Liver abscess: Difference between revisions
(Created page with "Liver abscesses in Western countries are caused by bacteria, so-called pyogenic liver abscess. In developing countries, liver abscesses are mostly caused by parasites. Liver abscesses mostly affect the right lobe of the liver. == Etiology == In many cases, the source cannot be identified (cryptogenic abscess). In cases where the source is identified, the following sources are the most common: * Ascending cholangitis (due to biliary obstruction) * Bacteraemia * Intraabd...") |
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Liver abscesses in Western countries are caused by bacteria, so-called pyogenic liver abscess. In developing countries, liver abscesses are mostly caused by parasites. Liver abscesses mostly affect the right lobe of the liver. | '''Liver abscesses''' in Western countries are caused by bacteria, so-called '''pyogenic liver abscess'''. In developing countries, liver abscesses are mostly caused by parasites. Liver abscesses mostly affect the right lobe of the liver. | ||
== Etiology == | == Etiology == | ||
In many cases, the source cannot be identified (cryptogenic abscess). In cases where the source is identified, the following sources are the most common: | In many cases, the source cannot be identified (cryptogenic abscess). In cases where the source is identified, the following sources are the most common: | ||
* Ascending cholangitis (due to biliary obstruction) | * Ascending [[cholangitis]] (due to biliary obstruction) | ||
* Bacteraemia | * [[Bacteraemia]] | ||
* Intraabdominal infection (appendicitis, diverticulitis) | * Intraabdominal infection ([[Acute appendicitis|appendicitis]], [[Diverticular disease (diverticulosis and diverticulitis)|diverticulitis]]) | ||
== Clinical features == | == Clinical features == | ||
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== Diagnosis and evaluation == | == Diagnosis and evaluation == | ||
Elevated inflammatory markers, abnormal liver function test, and positive blood culture is often present. | Elevated [[Inflammatory marker|inflammatory markers]], abnormal [[liver function test]], and positive [[blood culture]] is often present. | ||
Imaging shows hypoechoic/hypodense lesions, usually in the right lobe of the liver. An underlying source should also be sought on imaging. | Imaging shows hypoechoic/hypodense lesions, usually in the right lobe of the liver. An underlying source should also be sought on imaging. | ||
Latest revision as of 15:13, 27 October 2023
Liver abscesses in Western countries are caused by bacteria, so-called pyogenic liver abscess. In developing countries, liver abscesses are mostly caused by parasites. Liver abscesses mostly affect the right lobe of the liver.
Etiology
In many cases, the source cannot be identified (cryptogenic abscess). In cases where the source is identified, the following sources are the most common:
- Ascending cholangitis (due to biliary obstruction)
- Bacteraemia
- Intraabdominal infection (appendicitis, diverticulitis)
Clinical features
The classical features of pyogenic liver abscess are fever, malaise, and pain in the right upper quadrant. They may also have tender hepatomegaly and may develop jaundice if biliary obstruction occurs. There may also be clinical features of the underlying source.
Diagnosis and evaluation
Elevated inflammatory markers, abnormal liver function test, and positive blood culture is often present.
Imaging shows hypoechoic/hypodense lesions, usually in the right lobe of the liver. An underlying source should also be sought on imaging.
Treatment
Treatment includes antibiotics and drainage, as well as identifying the source. Drainage is often percutaneous, but in complicated cases surgical drainage may be necessary.