A liver abscess is a localized collection of pus within the liver, often resulting from an infection.
It is a serious condition that can lead to severe complications if not promptly diagnosed and appropriately treated.
Liver abscesses can be classified into two main types: pyogenic abscesses and amoebic abscesses.
- Pyogenic Abscess: Pyogenic liver abscesses are caused by bacteria, typically originating from the biliary tract, the portal vein, or through the bloodstream. Common bacteria responsible for pyogenic liver abscesses include Escherichia coli, Klebsiella, and Enterococcus species.
- Amebic Abscess: Amoebic liver abscesses are primarily caused by the parasite Entamoeba histolytica. These abscesses are more prevalent in developing countries and are often associated with poor sanitation and contaminated food or water.
Symptoms
The symptoms of a liver abscess may include:
- Fever
- Abdominal pain, especially in the upper right quadrant
- Nausea and vomiting
- Jaundice
- Loss of appetite
- Weight loss
- Fatigue
Diagnosis
Diagnosis of a liver abscess typically involves a combination of imaging tests, such as ultrasound, CT scan, or MRI, and laboratory tests, including blood cultures and liver function tests. These help identify the presence of an abscess, determine its size and location, and identify the causative organism. It is important to also exclude an underlying mass lesion such as cancer which may have developed an infection but requires more extensive treatment than just dealing with the infection alone.
Treatment
Treatment of a liver abscess often involves a combination of antibiotic therapy and, in some cases, drainage of the abscess. Antibiotics are administered intravenously to eliminate the underlying infection, while drainage may be performed using either percutaneous needle aspiration or surgical drainage, depending on the size and location of the abscess. Surgery may be possible using a laparoscopic or robotic approach.
Prompt and appropriate treatment is essential in managing liver abscesses and preventing potentially life-threatening complications, such as sepsis and liver failure. Follow-up care is crucial to ensure the complete resolution of the abscess and to monitor for any potential recurrence or complications.