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
