Liver abscess/cyst Flashcards
What is the defintion of liver abscess/cyst?
collections of thick fluid (cyst) or pus (abscess) containing dead cells, pathogens +/- blood
When are Liver abscess/cysts more common?
diabetic patients
What are 4 types of liver asbcess/cyst?
- Pyogenic abscess
- Amoebic abscess
- Hydatid Cyst
- PCLD
What are signs and symptoms of liver abscess/cyst?
- Fever
- Malaise
- Weight loss / loss of appetite
- RUQ pain
- Jaundice
- Tender hepatomegaly
- Dullness to percuss (ascites)
- Hx of foreign travel
What are Ix for liver asbcess/cyst?
- Bloods
- Stool cultures
- Aspiration and culture of lesion
- Imaging: Liver USS, CT or MRI
What bloods are done?
- FBC
- CRP
- LFTs
What imaging is done?
Liver USS, CT or MRI
What is the management of bacterial source liver ascess/cyst?
- drainage plus long course antibiotics
2. amoxicillin + ciprofloxacin + metronidazole
What is the management of amoebic source liver ascess/cyst?
antibiotics targeting anaerobes i.e. metronidazole
What is the management of hyatid abscess liver ascess/cyst?
- sterilisation with anti-fungals
- i.e. mebendazole then surgical resection
- Percutaneous aspiration contraindicated
What is the cause of pyogenic asbcess?
- S. Aureus (kids)
- E. Coli (adults)
What is a pyogenic abscess related to?
60% related to biliary disease e.g., gallstones, strictures
What would USS show in a pyogenic abscess?
fluid filled cavity with hyperechoic walls
What is the management of a pyogenic abscess?
drainage plus long course of antibiotics
What is the causative organism for an amoebic abscess?
Entamoeba histolytica
What is the symptoms for an amoebic abscess?
amoebic dysentery (profuse bloody diarrhoea)
What does USS show for liver asbcess?
fluid filled structure with poorly defined boundaries
What is the management of amoebic abscess?
- Aspiration = sterile, odourless fluid with pasty consistency
- Anaerobic antibiotics
What is the causative organism for hydatid cyst?
- Tapeworm Echinococcus granulosis infection
* Can be massive
Where are hydatid cysts common?
Sheep-rearing countries
What are hydatid cyst assoicated with?
- eosinophilia
2. abnormal LFTs
What is the management for a hydatid cyst?
Antifungals and surgical resection
What is polycystic liver disease associated with?
- Usually in association with PCKD
* AD disorder
