Liver abscess overview
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Liver abscess Main Page |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
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%.[1]. Biliary tract disease is the most common cause but no cause identified in the majority of patients. There are nonspecific clinical findings hence a high degree of suspicion required for diagnosis. There are most often single, rather than multiple foci. Hyperbilirubinemia and elevated alkaline phosphatase in the majority of patients, but low specificity. E. coli is the most prevalent organism, followed by Klebsiella, Streptococcus, and Bacteroides species. Rare cause is bowel perforation following foreign body ingestion. Therapy for solitary liver abscess from causes other than bowel perforation is intravenous antibiotics and percutaneous US- or CT-guided drainage. Therapy for liver abscess caused by bowel perforation or foreign body is open surgical drainage. Amebic liver abscess occurs in 94% of cases of amebiasis. Liver abscess is a relatively infrequent (1.7% according to Cho, D. et. al.), although possible, complication of percutaneous radiofrequency ablation of hepatic tumors.
Classification
Liver abscess may be classified into 3 types based on etiology into pyogenic, amoebic, and fungal liver abscess.