Satyendra Dhar, MD @DharSaty · 9 months ago
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Liver Abscess • Pyogenic abscess, accounts for 80% of abscess. • Amebic abscess due to Entamoeba histolytica, accounts for 10%. • Fungal
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Liver Abscess
•	Pyogenic abscess, accounts for 80% of abscess.
•	Amebic abscess due to Entamoeba histolytica, accounts for 10%.
•	Fungal abscess, accounts for < 10%.
•	50% of solitary liver abscesses occur in the right Liver lobe.
•	Right hepatic lobe (~75%), less commonly left (20%) or caudate (5%) lobes.
•	Pyogenic abscesses are usually polymicrobial.
•	50% of the bacterial cases develop by cholangitis. 
•	Pyogenic Abscess- initial manifestation of an occult intra‐abdominal malignancy (up to 15%).
•	Positive blood cultures in up to 50%.
•	Most common organisms: E. coli, Klebsiella, Streptococcus, Staphylococcus, & anaerobes.
•	K pneumoniae thought to be associated with colorectal cancer.
•	Fever in 90% & abdominal pain in about 50-75%.
•	In-hospital mortality estimated at 2.5% -19%

Drainage of the abscess & antibiotic treatment are the cornerstones of treatment.

•	Antibiotic Therapy: 
If the size of the abscess < 3-5 cm
Oral antibiotics are given after intravenous antibiotics are first administered. 
•	Percutaneous Drainage: 
Abscess > 5 cm
Continuous fever despite 48-72 hours of ABX therapy
Indications that the abscess may rupture
U/S or CT-guided aspiration & drainage- first-line treatment. 
•	Surgery:
Where percutaneous drainage is impractical.
When there are complications like rupture or numerous abscesses. 
Open surgery or laparoscopic surgery.

#Hepaticabscess #liverabscess #liver #abscess #Pyogenic #Amebic #Entamoebahistolytica #Klebsiella
Satyendra Dhar, MD @DharSaty · 9 months ago
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