Liver abscess Flashcards
What is a liver abscess?
Polymicrobial bacterial infection spreading from the biliary or GI tract
What are some causes of liver abscesses?
Cholecystitis, cholangitis, divertulitis, appendictis, septicaemia
What organisms usually cause liver abscesses?
E coli, K pneumoniae and S constellatus, fungi causes as well
What is the presentation of liver abscesses?
Fever, rigors and abdominal pain, bloating, nausea, anorexia, weight loss, fatigue and jaundice
What would you find on examination of a patient with liver abscesses?
RUQ tenderness and hepatomegaly
What will blood tests show for liver abscess?
Leucocytosis, Raised ALP and deranged ALT and bilirubin
What will an ultrasound of a liver abscess show?
poor defined lesion, with hypertension and hyper echoic areas with potential bubbles and separations
What further imaging can you do for liver abscesses?
CT imaging with contrast will reveal a similar pattern with the collection as seen on US with associated surrounding oedema
What is the management for liver abscesses?
antibiotic therapy and drainage via imagine guided aspiration of the abscess
What is an amoebic abscess?
most common extra-intestinal manifectation of amebiasis infection caused by Entamoeba histolytica
How does entamoeba histolytica spread to the liver?
via the portal system
What are the clinical features of an amoebic abscess?
vague symptoms such as abdominal pain, nausea, fever or rigors, weight loss and bloating, recent travel,
What are the investigations for amoebic abscess?
leucocytosis and deranged LFTs, will have E histolytica antibodies, ultrasound will show poor defined lesions
What is the management for an amoebic abscess?
Antibiotics alone, may have surgical drainage if large
