Liver abscess

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Liver abscess Classification and external resources
ICD-10	K75.0
ICD-9	572.0
DiseasesDB	22094
eMedicine	med/1316
MeSH	D008100

A liver abscess is a pus-filled mass inside or attached to the liver. Common causes are an abdominal infection such as appendicitis or diverticulitis. With treatment, the death rate is 10-30%.^[1]

Contents 1 Types 2 Amoebic liver abscess 2.1 Clinicals 2.2 Diagnosis 2.3 Management 3 Pyogenic liver abscess 3.1 Etiology 3.2 Clinical features 3.3 Diagnosis 3.4 Treatment 4 References

[edit] Types

There are three major forms of liver abscess, classified by etiology:

• Pyogenic abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess cases in the United States.
• Amoebic abscess due to Entamoeba histolytica accounts for 10% of cases.
• Fungal abscess, most often due to Candida species, accounts for less than 10% of cases.

[edit] Amoebic liver abscess

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[edit] Clinicals

• 1. Symptoms
• Pain Right Hypochondrium referred to Right shoulder
• Pyrexia (100.4 F)
• Profused sweating and Rigors
• Loss of Weight
• Earthy Complexion
• 2. Signs
• Pallor
• Tenderness and rigidity in right hypochondrium
• Palpable Liver
• Intercostal Tenderness
• Basal Lung Signs

[edit] Diagnosis

• Blood CP
• Haemoglobin Estimation
• Stools Examination (Trophozoites and Cysts)
• Radiography
• Aspiration Exploratory
• Medical ultrasonography and CT Scanning
• Sigmoidoscopy
• Liver function tests
• Serological Tests

[edit] Management

• Metronidazole 800mg TDS for 5-10 days
• Aspiration
• Repeated Imaging Of Liver

[edit] Pyogenic liver abscess

[edit] Etiology

• Streptococcus milleri
• E. coli
• Streptococcus fecalis
• Klebsiella
• Proteus vulgaris
• Opportunistic Pathogens (Staphylococcus)

[edit] Clinical features

• 1.Acute Abscess
• Fever
• Lethargy
• Discomfort in Right Upper Quadrant Of Abdomen
• Anorexia
• Enlarged and Tender Liver
• Pleural effusion

• 2.Chronic Abscess
• Fever
• Abdominal discomfort
• Enlarged Liver

[edit] Diagnosis

• Blood CP (No Leucocytosis)
• Haemoglobin estimation (anaemia)
• Serum albumin levels (Falls rapidly)
• USG and CT Scanning

[edit] Treatment

• 1.Antibiotics
• Penicillins
• Aminoglycosides
• Metronidazole
• Cephalosporins
• 2.Percutaneous Drainage under USG or CT Control
• 3.Laparotomy in intraabdominal disease

[edit] References

1. ^ 'MedlinePlus Medical Encyclopedia: Pyogenic liver abscess'.

v • d • e Digestive system - Digestive disease - Gastroenterology (primarily K20-K93, 530-579) Esophagus Esophagitis - GERD - Achalasia - Boerhaave syndrome - Nutcracker esophagus - Zenker's diverticulum - Mallory-Weiss syndrome - Barrett's esophagus Stomach/ duodenum Peptic (gastric/duodenal) ulcer - Gastritis - Gastroenteritis - Duodenitis - Dyspepsia - Pyloric stenosis - Achlorhydria - Gastroparesis - Gastroptosis - Portal hypertensive gastropathy - Gastric antral vascular ectasia Hernia Inguinal (Indirect, Direct) - Femoral - Umbilical - Incisional - Diaphragmatic - Hiatus Noninfective enteritis & colitis Inflammatory bowel disease (IBD, Crohn's disease, Ulcerative colitis) - noninfective gastroenteritis Other intestinal vascular (Abdominal angina, Mesenteric ischemia, Ischemic colitis, Angiodysplasia) - Ileus/Bowel obstruction (Intussusception, Volvulus) - Diverticulitis/Diverticulosis - Irritable bowel syndrome (IBS) other functional intestinal disorders (Constipation, Diarrhea, Megacolon/Toxic megacolon, Proctalgia fugax) - Anal fissure/Anal fistula - Anal abscess - Rectal prolapse - Proctitis (Radiation proctitis) Liver/hepatitis Alcoholic liver disease - Liver failure (Hepatic encephalopathy, Acute liver failure) - Cirrhosis - PBC - Liver abscess - Autoimmune hepatitis - NASH - Fatty liver - Peliosis hepatis - Hepatic veno-occlusive disease - Portal hypertension - Hepatorenal syndrome Accessory digestive Gallbladder: Gallstones - Choledocholithiasis - Cholecystitis - Cholesterolosis - Rokitansky-Aschoff sinuses Biliary tree: Cholangitis - Cholestasis/Mirizzi's syndrome - PSC - Biliary fistula - Ascending cholangitis Pancreatic: Acute pancreatitis - Chronic pancreatitis - Pancreatic pseudocyst - Hereditary pancreatitis - Exocrine pancreatic insufficiency - Pancreatic fistula Other/general Appendicitis - Peritonitis (Spontaneous bacterial peritonitis) Malabsorption (coeliac, Tropical sprue, Blind loop syndrome, Whipple's) postprocedural: Gastric dumping syndrome - Postcholecystectomy syndrome bleeding: Hematemesis - Melena - Gastrointestinal bleeding (Upper, Lower) See also congenital