Pyogenic liver abscess pathophysiology: Difference between revisions

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==Pathophysiology==
==Pathophysiology==
*Development of pyogenic liver abscess is the result of extension of infection through the following:<ref name="pmid17861705">{{cite journal| author=Munro JC| title=VII. Lymphatic and Hepatic Infections Secondary to Appendicitis. | journal=Ann Surg | year= 1905 | volume= 42 | issue= 5 | pages= 692-734 | pmid=17861705 | doi= | pmc=1425980 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17861705  }} </ref>
*Development of pyogenic liver abscess is the result of extension of infection through the following:<ref name="pmid17861705">{{cite journal| author=Munro JC| title=VII. Lymphatic and Hepatic Infections Secondary to Appendicitis. | journal=Ann Surg | year= 1905 | volume= 42 | issue= 5 | pages= 692-734 | pmid=17861705 | doi= | pmc=1425980 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17861705 }} </ref><ref name="pmid8651751">{{cite journal| author=Huang CJ, Pitt HA, Lipsett PA, Osterman FA, Lillemoe KD, Cameron JL et al.| title=Pyogenic hepatic abscess. Changing trends over 42 years. | journal=Ann Surg | year= 1996 | volume= 223 | issue= 5 | pages= 600-7; discussion 607-9 | pmid=8651751 | doi= | pmc=1235191 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8651751  }} </ref><ref name="pmid15578367">{{cite journal| author=Rahimian J, Wilson T, Oram V, Holzman RS| title=Pyogenic liver abscess: recent trends in etiology and mortality. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 11 | pages= 1654-9 | pmid=15578367 | doi=10.1086/425616 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15578367  }} </ref><ref name="pmid10462653">{{cite journal| author=Lam YH, Wong SK, Lee DW, Lau JY, Chan AC, Yiu RY et al.| title=ERCP and pyogenic liver abscess. | journal=Gastrointest Endosc | year= 1999 | volume= 50 | issue= 3 | pages= 340-4 | pmid=10462653 | doi=10.1053/ge.1999.v50.98065 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10462653 }} </ref>
:*Portal vein
:*Portal vein
:*Hepatic arteries as metastatic abscessess
:*Hepatic arteries as metastatic abscessess

Revision as of 20:03, 21 February 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Overview

Pathophysiology

  • Development of pyogenic liver abscess is the result of extension of infection through the following:[1][2][3][4]
  • Portal vein
  • Hepatic arteries as metastatic abscessess
  • Direct spread from nearby infection
  • Trauma
  • Retroperitoneal extension from appendix (suppurative appendicitis most frequent source of infection)
  • Ascending biliary infection is the most common source of pyogenic liver abscess
  • Bacteria involved in pyogenic liver abscess include:
 
 
 
 
 
 
 
 
 
 
 
Pyogenic liver abscess
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Bacteria
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Gram-positive aerobes
 
 
 
Gram-negative enterics
 
 
 
Anaerobic organisms
 
 
 
Acid fast bacilli
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Streptococcus sp
Staphylococcus aureus / Staphylococcus epidermidis
Actinomyces sp
Enterococcus sp
Streptococcus milleri
 
 
 
Escherichia coli
Salmonella typhi
Yersinia enterocolitica
K.pneumonia
Pseudomonas sp
Proteus sp
Eikenella corrodens
Others
 
 
 
Bacteroids sp
Fusobacterium
Anaerobic/ Microaerophilic streptococci
Other anaerobes
 
 
 
Mycobacterium tuberculosis

References

  1. Munro JC (1905). "VII. Lymphatic and Hepatic Infections Secondary to Appendicitis". Ann Surg. 42 (5): 692–734. PMC 1425980. PMID 17861705.
  2. Huang CJ, Pitt HA, Lipsett PA, Osterman FA, Lillemoe KD, Cameron JL; et al. (1996). "Pyogenic hepatic abscess. Changing trends over 42 years". Ann Surg. 223 (5): 600–7, discussion 607-9. PMC 1235191. PMID 8651751.
  3. Rahimian J, Wilson T, Oram V, Holzman RS (2004). "Pyogenic liver abscess: recent trends in etiology and mortality". Clin Infect Dis. 39 (11): 1654–9. doi:10.1086/425616. PMID 15578367.
  4. Lam YH, Wong SK, Lee DW, Lau JY, Chan AC, Yiu RY; et al. (1999). "ERCP and pyogenic liver abscess". Gastrointest Endosc. 50 (3): 340–4. doi:10.1053/ge.1999.v50.98065. PMID 10462653.