Liver Abscesses Flashcards
What are the causes of liver abscesses. (4)
Bacterial.
Helminthic.
Fungal.
Protozoal.
How are the causative organisms of liver abscesses spread. (4)
Blood.
Post-traumatic.
Directly.
Via biliary tree.
What are the clinical signs of a liver abscess. (8)
Fever (and occasionally rigors and weight loss).
RUQ pain/tenderness (may radiate to right shoulder).
The pain may be pleuritic in nature.
Right sided pleural effusion.
Tender hepatomegaly (more then 50%).
Mild jaundice may be present (becomes severe is large abscesses cause biliary obstruction).
Septicaemia.
Rupture.
How are liver abscesses classified. (3)
Pyogenic.
Hydatid.
Amoebic.
What is the mortality rate for pyogenic liver abscesses.
20-40%.
Why are pyogenic liver abscesses important. (4)
They are uncommon.
Important because they are potential curable, carry significant morbidity and mortality if untreated.
They are potentially overlooked.
Who is most commonly affected by pyogenic liver abscesses.
The elderly.
What are the causes of pyogenic liver abscesses. (6)
Biliary obstruction (cholangitis). Portal vein (mesenteric infections). Hepatic artery (bacteraemia). Direct extension. Trauma (penetrating or non-penetrating). Infections of liver tumour of cyst.
What is the cause of hydatid cysts of the liver.
Echinococcus granulosus infection.
How are hydatid cysts seen on AXR.
May show calcification of the rim of the abscess.
How can hydatid cysts cause biliary obstruction.
Rupture or secondary infection of the cysts can occur, and a communication with the intrahepatic biliary tree can result.
What causes amoebic liver abscesses.
They are caused by Entamoeba histolytica infection.
What is the pathology of amoebic liver abscesses. (3)
Usually large, single and located in the right lobe.
