Liver abscess


Liver abscess

Infobox_Disease
Name = PAGENAME


Caption =
DiseasesDB = 22094
ICD10 = ICD10|K|75|0|k|70
ICD9 = ICD9|572.0
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj = med
eMedicineTopic = 1316
MeshID = D008100
A liver abscess is a pus-filled mass inside or attached to the liver. Common causes are an abdominal infection such as appendicitis or diverticulitis. With treatment, the death rate is 10-30%.cite web | url=http://www.nlm.nih.gov/medlineplus/ency/article/000261.htm | title='MedlinePlus Medical Encyclopedia: Pyogenic liver abscess']

Types

There are three major forms of liver abscess, classified by etiology:

* Pyogenic abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess cases in the United States.
* Amoebic abscess due to "Entamoeba histolytica" accounts for 10% of cases.
* Fungal abscess, most often due to "Candida" species, accounts for less than 10% of cases.

Amoebic liver abscess

Clinicals

* 1. Symptoms
* Pain Right Hypochondrium referred to Right shoulder
* Pyrexia (100.4 F)
* Profused sweating and Rigors
* Loss of Weight
* Earthy Complexion
* 2. Signs
* Pallor
* Tenderness and rigidity in right hypochondrium
* Palpable Liver
* Intercostal Tenderness
* Basal Lung Signs

Diagnosis

* Blood CP
* Haemoglobin Estimation
* Stools Examination (Trophozoites and Cysts)
* Radiography
* Aspiration Exploratory
* Medical ultrasonography and CT Scanning
* Sigmoidoscopy
* Liver function tests
* Serological Tests

Management

* Metronidazole 800mg TDS for 5-10 days
* Aspiration
* Repeated Imaging Of Liver

Pyogenic liver abscess

Etiology

* Streptococcus milleri
* E. coli
* Streptococcus fecalis
* Klebsiella
* Proteus vulgaris
* Opportunistic Pathogens (Staphylococcus)

Clinical features

* 1.Acute Abscess
* Fever
* Lethargy
* Discomfort in Right Upper Quadrant Of Abdomen
* Anorexia
* Enlarged and Tender Liver
* Pleural effusion

* 2.Chronic Abscess
* Fever
* Abdominal discomfort
* Enlarged Liver

Diagnosis

* Blood CP (No Leucocytosis)
* Haemoglobin estimation (anaemia)
* Serum albumin levels (Falls rapidly)
* USG and CT Scanning

Treatment

* 1.Antibiotics
* Penicillins
* Aminoglycosides
* Metronidazole
* Cephalosporins
* 2.Percutaneous Drainage under USG or CT Control
* 3.Laparotomy in intraabdominal disease

References


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