Chapter 51: Liver- Bacterial Liver Abscess

Question 1

What are the three most common bacterial organisms affecting the liver?

Answer 1

Gram negatives:

1. E. coli
2. Klebsiella
3. Proteus

Question 2

What are the most common sources/causes of bacterial liver abscesses?

Answer 2

1. Cholangitis
2. diverticulitis
3. liver cancer
4. liver metastasis

Question 3

What are the signs/symptoms?

Answer 3

1. Fever
2. chills
3. RUQ pain
4. leukocytosis increased liver function tests (LFTs)
5. jaundice
6. sepsis
7. weight loss

Question 4

What is the treatment?

Answer 4

1. IV antibiotics (triple antibiotics with metronidazole)
2. percutaneous drainage with CT scan or U/S guidance

Question 5

What are the indications for operative drainage?

Answer 5

Multiple/loculated abscesses or if multiple percutaneous attempts have failed