Liver Abscess

Liver abscess
Liver abscess on axial CT image: a hypodense lesion in the liver with peripherally enhancement.

A liver abscess is a mass filled with pus inside the liver.^[1] Common causes are abdominal conditions such as appendicitis or diverticulitis due to haematogenous spread through the portal vein.^[2] It can also develop as a complication of a liver injury.

Signs and symptoms[edit | edit source]

The clinical presentation for a liver abscess is consistent with:^[3]

• Fever
• Night sweats
• Malaise
• Vomiting

Causes[edit | edit source]

Risk factors for developing liver abscess can be due to infection, post-procedural infection and metastasis such as primary liver tumours, liver metastasis, biliary procedures, biliary injuries, biliary tract disease, appendicitis, and diverticulitis.^{[citation needed]}

Major bacterial causes of liver abscess include the following:^[4]

• Streptococcus species (including Enterococcus)
• Escherichia species
• Staphylococcus species
• Klebsiella species (Higher rates in the Far East)
• Anaerobes (including Bacteroides species)
• Pseudomonas species
• Proteus species
• Entamoeba Histolytica

However, as noted above, many cases are polymicrobial.

Diagnosis[edit | edit source]

Types[edit | edit source]

There are several major forms of liver abscess, classified by cause:^{[citation needed]}

• Pyogenic liver abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess cases in the United States.
• Amoebic liver abscess due to Entamoeba histolytica accounts for 10% of cases. The incidence is much higher in developing countries.
• Fungal abscess, most often due to Candida species, accounts for less than 10% of cases.
• Iatrogenic abscess, caused by medical interventions

• 

  a) Fluoroscopic view shows contrast in collapsed liver abscess red arrow b) fluoroscopic view shows contrast tracking from the liver abscess red arrow

• 

  A large pyogenic liver abscess presumed to be the result of appendicitis

Management[edit | edit source]

Antibiotics: IV metronidazole and third generation cephalosporin/quinolones, β-lactam antibiotics, and aminoglycosides are effective.^{[citation needed]}

Prognosis[edit | edit source]

The prognosis has improved for liver abscesses. The mortality rate in-hospital is about 2.5-19%. The elderly, ICU admissions, shock, cancer, fungal infections, cirrhosis, chronic kidney disease, acute respiratory failure, severe disease, or disease of biliary origin have a worse prognosis.^[3]

References[edit | edit source]

External links[edit | edit source]

Classification	ICD-10: K75.0 ICD-9-CM: 572.0 MeSH: D008100 DiseasesDB: 22094
External resources	MedlinePlus: 000261 eMedicine: med/1316

• Liver Abscess CT Images Archived 2016-03-04 at the Wayback Machine CTCases Liver Abscess CT Scan.