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
