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.

## Contents

* 1 Signs and symptoms
* 2 Causes
* 3 Diagnosis
* 3.1 Types
* 4 Management
* 5 Prognosis
* 6 References
* 7 External links

## 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]

1. ↑ "Liver Abscess Definition in Medical Conditions Dictionary". medconditions.net. 11 April 2018. Archived from the original on 5 April 2012. Retrieved 11 April 2018.
2. ↑ MedlinePlus Encyclopedia: Pyogenic liver abscess
3. ↑ 3.0 3.1 Akhondi H, Sabih DE (2019). "Liver Abscess". StatPearls. StatPearls Publishing. PMID 30855818. Archived from the original on 2021-05-03. Retrieved 2019-07-28.
4. ↑ Webb GJ, Chapman TP, Cadman PJ, Gorard DA (January 2014). "Pyogenic liver abscess". Frontline Gastroenterology. 5 (1): 60–67. doi:10.1136/flgastro-2013-100371. PMC 5369710. PMID 28839753.

## 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.

* v
* t
* e

Diseases of the digestive system

Upper GI tract|

| Esophagus|

* Esophagitis
* Candidal
* Eosinophilic
* Herpetiform
* Rupture
* Boerhaave syndrome
* Mallory–Weiss syndrome
* UES
* Zenker's diverticulum
* LES
* Barrett's esophagus
* Esophageal motility disorder
* Nutcracker esophagus
* Achalasia
* Esophagogastric junction outflow obstruction
* Diffuse esophageal spasm
* Gastroesophageal reflux disease (GERD)
* Laryngopharyngeal reflux (LPR)
* Esophageal stricture
* Megaesophagus
* Esophageal intramural pseudodiverticulosis
* Acute esophageal necrosis

|

Stomach|

* Gastritis
* Atrophic
* Ménétrier's disease
* Gastroenteritis
* Peptic (gastric) ulcer
* Cushing ulcer
* Dieulafoy's lesion
* Dyspepsia
* Pyloric stenosis
* Achlorhydria
* Gastroparesis
* Gastroptosis
* Portal hypertensive gastropathy
* Gastric antral vascular ectasia
* Gastric dumping syndrome
* Gastric volvulus
* Buried bumper syndrome
* Gastrinoma
* Zollinger–Ellison syndrome

Lower GI tract
Enteropathy|

| Small intestine
(Duodenum/Jejunum/Ileum)|

* Enteritis
* Duodenitis
* Jejunitis
* Ileitis
* Peptic (duodenal) ulcer
* Curling's ulcer
* Malabsorption: Coeliac
* Tropical sprue
* Blind loop syndrome
* Small intestinal bacterial overgrowth
* Whipple's
* Short bowel syndrome
* Steatorrhea
* Milroy disease
* Bile acid malabsorption

|

Large intestine
(Appendix/Colon)|

* Appendicitis
* Colitis
* Pseudomembranous
* Ulcerative
* Ischemic
* Microscopic
* Collagenous
* Lymphocytic
* Functional colonic disease
* IBS
* Intestinal pseudoobstruction / Ogilvie syndrome
* Megacolon / Toxic megacolon
* Diverticulitis/Diverticulosis/SCAD

Large and/or small|

* Enterocolitis
* Necrotizing
* Gastroenterocolitis
* IBD
* Crohn's disease
* Vascular: Abdominal angina
* Mesenteric ischemia
* Angiodysplasia
* Bowel obstruction: Ileus
* Intussusception
* Volvulus
* Fecal impaction
* Constipation
* Diarrhea
* Infectious
* Intestinal adhesions

Rectum|

* Proctitis
* Radiation proctitis
* Proctalgia fugax
* Rectal prolapse
* Anismus

Anal canal|

* Anal fissure/Anal fistula
* Anal abscess
* Hemorrhoid
* Anal dysplasia
* Pruritus ani

GI bleeding|

* Blood in stool
* Upper
* Hematemesis
* Melena
* Lower
* Hematochezia

Accessory|

| Liver|

* Hepatitis
* Viral hepatitis
* Autoimmune hepatitis
* Alcoholic hepatitis
* Cirrhosis
* PBC
* Fatty liver
* NASH
* Vascular
* Budd–Chiari syndrome
* Hepatic veno-occlusive disease
* Portal hypertension
* Nutmeg liver
* Alcoholic liver disease
* Liver failure
* Hepatic encephalopathy
* Acute liver failure
* Liver abscess
* Pyogenic
* Amoebic
* Hepatorenal syndrome
* Peliosis hepatis
* Metabolic disorders
* Wilson's disease
* Hemochromatosis

|

Gallbladder|

* Cholecystitis
* Gallstone / Cholelithiasis
* Cholesterolosis
* Adenomyomatosis
* Postcholecystectomy syndrome
* Porcelain gallbladder

Bile duct/
Other biliary tree|

* Cholangitis
* Primary sclerosing cholangitis
* Secondary sclerosing cholangitis
* Ascending
* Cholestasis/Mirizzi's syndrome
* Biliary fistula
* Haemobilia

* Common bile duct
* Choledocholithiasis
* Biliary dyskinesia
* Sphincter of Oddi dysfunction

Pancreatic|

* Pancreatitis
* Acute
* Chronic
* Hereditary
* Pancreatic abscess
* Pancreatic pseudocyst
* Exocrine pancreatic insufficiency
* Pancreatic fistula

Other|

| Hernia|

* Diaphragmatic
* Congenital
* Hiatus

* Inguinal
* Indirect
* Direct
* Umbilical
* Femoral
* Obturator
* Spigelian

* Lumbar
* Petit's
* Grynfeltt-Lesshaft

* Undefined location
* Incisional
* Internal hernia
* Richter's

|

Peritoneal|

* Peritonitis
* Spontaneous bacterial peritonitis
* Hemoperitoneum
* Pneumoperitoneum

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