Liver abscesses – from diagnosis to treatment

Abstract

A liver abscess is a limited, often encysted, purulent inflammation with parenchymal necrosis that is a life-threatening complication of bacterial, fungal, protozoal and worm infections. Liver abscesses can be single or multi-ple; most of them are located in the right liver lobe. The pathogenic factor responsible for the development of abscesses can be identified by collecting the lesion’s contents or the cultures of blood, bile, sometimes urine or stool samples. Diagnosis is established by serological, imaging and microscopic tests. The treatment regimen is determined mainly by the etiological factor and the size of the lesion and includes conservative treatment and mainly percutaneous procedures. The article briefly presents the epidemiology, clinical picture and the current approach to the diagnosis and treatment of liver abscesses.

Management of Pyogenic Liver Abscesses

“…Abscesses from the biliary tract are usually multiple and affect both lobes of the liver. 6 Infections originating from portal venous drainage remain an important cause of PLAs. Diverticular disease and colon cancer represent the commonest pathologies leading to PLA from portal venous drainage.…”

“…Obstruction can be due to gallstones, cholecystitis, tumor, occluded stent—and, less commonly, invasion of helminths (eg, Ascaris lumbricoides ) into the biliary tree. Abscesses from the biliary tract are usually multiple and affect both lobes of the liver 6 …”

Observational Study of Clinical Profiles and Management of Liver Abscess in Hospitalized Patients: A North Indian Tertiary Care Perspective

“…Liver abscesses are serious and potentially life-threatening infections characterized by localized collections of pus within the liver parenchyma [ 1 ]. Prompt diagnosis and appropriate management are crucial for optimizing patient outcomes [ 2 ].…”

“…cholangitis, appendicitis, etc. ), trauma, and invasive interventions involving the hepato-biliary system [ 1 ]. Sometimes, cystic masses of the liver, like hydatid cysts, may become secondarily infected by bacteria and present like PLA.…”

“…Escherichia coli, Klebsiella pneumonia, and Enterococcus species were the most common isolates from PLA aspirates. Accurate diagnosis relies on imaging techniques and laboratory investigations in the background of clinical features and predisposing conditions [ 1 ]. Management typically involves antimicrobial therapy, percutaneous drainage (needle aspiration or catheter drainage), and rarely, surgical intervention [ 3 ].…”