Pyogenic liver abscess overview

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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

Historical Perspective

Hippocrates described pyogenic liver abscess based on the type of fluid recovered from abscess. In 1938, Ocshner and colleagues reported that the major causal factors leading to hepatic abscess were appendicitis and amoebiasis.[1]

Classification

Pyogenic liver abscess may be classified according to international classification of diseases-10 (ICD-10) into K75.0.[2].

Pathophysiology

Development of pyogenic liver abscess is the result of infection through the following routes like portal vein (also from pyelophlebitis of portal vein), hepatic arteries as metastatic abscesses, direct spread from nearby infection, trauma and retroperitoneal extension from appendix.[3][1][4][5]Ascending biliary infection is the most common source of pyogenic liver abscess.

Causes

Common causes of pyogenic liver abscess include hepatobiliary, portal, arterial, traumatic and cryptogenic causes.

Differential Diagnosis

Pyogenic liver abscess must be differentiated from other diseases with similar presentation such as amoebic liver abscess, fungal liver abscess, echinococcal (hydatid) cyst and malignancy (hepatocelluar carcinoma or metastasis).[6][7][8][9]

Risk Factors

Screening

Natural History, Complications and Prognosis

References

  1. 1.0 1.1 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.
  2. http://www.icd10data.com/ICD10CM/Codes/K00-K95/K70-K77/K75-/K75.0 Accessed on February 22, 2017
  3. Munro JC (1905). "VII. Lymphatic and Hepatic Infections Secondary to Appendicitis". Ann Surg. 42 (5): 692–734. PMC 1425980. PMID 17861705.
  4. 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.
  5. 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.
  6. Lodhi S, Sarwari AR, Muzammil M, Salam A, Smego RA (2004). "Features distinguishing amoebic from pyogenic liver abscess: a review of 577 adult cases". Trop Med Int Health. 9 (6): 718–23. doi:10.1111/j.1365-3156.2004.01246.x. PMID 15189463.
  7. Barbour GL, Juniper K (1972). "A clinical comparison of amebic and pyogenic abscess of the liver in sixty-six patients". Am J Med. 53 (3): 323–34. PMID 5054724.
  8. Barnes PF, De Cock KM, Reynolds TN, Ralls PW (1987). "A comparison of amebic and pyogenic abscess of the liver". Medicine (Baltimore). 66 (6): 472–83. PMID 3316923.
  9. Conter RL, Pitt HA, Tompkins RK, Longmire WP (1986). "Differentiation of pyogenic from amebic hepatic abscesses". Surg Gynecol Obstet. 162 (2): 114–20. PMID 3945889.