Liver Abscess
(Short Answer)
Aetiology
Bacterial, parasitic or fungal in origin
In India amoebic liver abscess - common in alcoholics - Entamoeba histolytica
Inflammatory bowel disease
Pathophysiology
Amoebic cyst is ingested
cysts develop into trozoite form inthe colon
reach liver thru portal circulation
Pyogenic abscess - due to secondary infection - Streptococcus milleri and Escherichia coli
Clinical Manifestations
Fever
Right hypochondrium may be swollen
Discomfort or Pain right hypochondrium
Chills
Rigors
Toxicity
Diarrhoea
Weight loss
Intercostal tenderness
Tender, enlarge liver
Investigations
USGM
X-ray chest - pneumonitis, effusion looked for. secondary to the liver abscess
CBC : TC - Leucocytosis Abnormal LFT
USGM Abdomen
CT Scan - heterogenous lesion with irregular margins, internal septations, pus collection seen
Treatment
Percutaneous needle aspirations, surgical drainage, antibiotics like cephalosporins, aminoglycosides, tetracyclines; Metonidazole. Rarely insertion of a drain
Complications
Pneumonitis
Pleural effusion
Rupture of liver abscess into the pleural cavity → empyema
Rupture into peritoneal cavity
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CT Scan Liver - darker area - abscess
