Liver Abscesses Flashcards
What is a liver abscess?
Liver infection resulting in a walled off collection of pus
What causes Amoebic abscesses?
Entamoeba histolytica
What causes pyogenic abscesses?
E. coli Klebsiella Enterococcus Streptococci Staphylococci Biliary tract disease
List 3 signs of liver abscesses
Fever: continuous or spiking + chills
Jaundice (uncommon)
Tender hepatomegaly (right lobe affected more than left)
What may be seen on bloods in liver abscesses?
Mild anaemia Leukocytosis High eosinophils (if hydatid disease) Abnormal LFTs High ESR + CRP: used to modulate therapy Amoebic + hydatid serology
What may be seen on LFTs in liver abscesses?
High ALP
High BR/ ALT
Low albumin
What investigations may be performed for suspected liver abscesses?
Bloods
Blood cultures
Stool MC+S: E. histolytica
Liver US or CT/ MRI
Why perform Liver US or CT/MRI for liver abscesses?
Localises structure of mass (hypodense)
Mainly to guide aspiration
Why perform CXR for liver abscesses?
Check for right pleural effusion or atelectasis, raised hemidiaphragm
Only indicated if chest Sx or signs OE
Describe aspiration and culture results of liver abscesses
Most pyogenic abscesses: polymicrobial
Amoebic abscesses: fluid of necrotic hepatocytes + trophozoites
If a liver abscess causes a reactive pleural effusion, what will be found on examination?
Right lung base:
Dullness to percussion
Reduced breath sounds
What should you ask about when taking the history of a patient with suspected liver abscess?
Foreign travel (Central+S.America, Africa + Asia) Increases risk for Amoebic abscesses
