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Liver abscess Classification and external resources
ICD-10	K75.0
ICD-9	572.0
DiseasesDB	22094
eMedicine	med/1316
MeSH	D008100

A liver abscess is a pus-filled mass inside or attached to the liver. Common causes are an abdominal infection such as appendicitis or diverticulitis. With treatment, the death rate is 10-30%.^[1]

Contents 1 Types 2 Amoebic liver abscess 2.1 Clinicals 2.2 Diagnosis 2.3 Management 3 Pyogenic liver abscess 3.1 Etiology 3.2 Clinical features 3.3 Diagnosis 3.4 Treatment 4 References

Types

There are three major forms of liver abscess, classified by etiology:

• Pyogenic abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess cases in the United States.
• Amoebic abscess due to Entamoeba histolytica accounts for 10% of cases.
• Fungal abscess, most often due to Candida species, accounts for less than 10% of cases.

Amoebic liver abscess

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Clinicals

• 1. Symptoms
• Pain Right Hypochondrium referred to Right shoulder
• Pyrexia (100.4 F)
• Profused sweating and Rigors
• Loss of Weight
• Earthy Complexion
• 2. Signs
• Pallor
• Tenderness and rigidity in right hypochondrium
• Palpable Liver
• Intercostal Tenderness
• Basal Lung Signs

Diagnosis

• Blood CP
• Haemoglobin Estimation
• Stools Examination (Trophozoites and Cysts)
• Radiography
• Aspiration Exploratory
• Medical ultrasonography and CT Scanning
• Sigmoidoscopy
• Liver function tests
• Serological Tests

Management

• Metronidazole 800mg TDS for 5-10 days
• Aspiration
• Repeated Imaging Of Liver

Pyogenic liver abscess

Etiology

• Streptococcus milleri
• E. coli
• Streptococcus fecalis
• Klebsiella
• Proteus vulgaris
• Opportunistic Pathogens (Staphylococcus)

Clinical features

• 1.Acute Abscess
• Fever
• Lethargy
• Discomfort in Right Upper Quadrant Of Abdomen
• Anorexia
• Enlarged and Tender Liver
• Pleural effusion

• 2.Chronic Abscess
• Fever
• Abdominal discomfort
• Enlarged Liver

Diagnosis

• Blood CP (No Leucocytosis)
• Haemoglobin estimation (anaemia)
• Serum albumin levels (Falls rapidly)
• USG and CT Scanning

Treatment

• 1.Antibiotics
• Penicillins
• Aminoglycosides
• Metronidazole
• Cephalosporins
• 2.Percutaneous Drainage under USG or CT Control
• 3.Laparotomy in intraabdominal disease

References

1. ^ "'MedlinePlus Medical Encyclopedia: Pyogenic liver abscess'".

v • d • e Digestive system - Digestive disease - Gastroenterology (primarily K20-K93, 530-579) Upper GI tract Esophagus Esophagitis (Candidal) - Boerhaave syndrome - UES (Zenker's diverticulum) - LES (Barrett's esophagus, Mallory-Weiss syndrome) - Esophageal motility disorder (Nutcracker esophagus, Achalasia, Diffuse esophageal spasm, GERD) - Esophageal stricture - Megaesophagus Stomach Gastritis (Atrophic, Ménétrier's disease, Gastroenteritis) - Peptic (gastric) ulcer/Dieulafoy's lesion - Dyspepsia - Pyloric stenosis - Achlorhydria - Gastroparesis - Gastroptosis - Portal hypertensive gastropathy - Gastric antral vascular ectasia - Gastric dumping syndrome - Gastric volvulus Intestinal/ enteropathy Small intestine/ (duodenum/jejunum/ileum) Enteritis (Duodenitis, Jejunitis, Ileitis) Peptic (duodenal) ulcer Malabsorption: Coeliac - Tropical sprue - Blind loop syndrome - Whipple's - Short bowel syndrome - Steatorrhea Large intestine (appendix/colon) Appendicitis - Colitis (Pseudomembranous, Ulcerative, Ischemic) Functional colonic disease (IBS, Intestinal pseudoobstruction/Ogilvie syndrome) Megacolon/Toxic megacolon - Diverticulitis/Diverticulosis Large and/or small Enterocolitis (Necrotizing) - IBD (Crohn's disease) vascular: Abdominal angina - Mesenteric ischemia - Angiodysplasia Bowel obstruction: Ileus - Intussusception - Volvulus - Fecal impaction Constipation - Diarrhea Rectum/anus Proctitis (Radiation proctitis) - Proctalgia fugax - Rectal prolapse - Anal fissure/Anal fistula - Anal abscess Accessory Liver Hepatitis (Viral hepatitis, Autoimmune hepatitis, Alcoholic hepatitis) - Cirrhosis (PBC) - Fatty liver (NASH) - vascular (Hepatic veno-occlusive disease, Portal hypertension, Nutmeg liver) - Alcoholic liver disease - Liver failure (Hepatic encephalopathy, Acute liver failure) - Liver abscess - Hepatorenal syndrome - Peliosis hepatis Gallbladder Cholecystitis - Gallstones/Cholecystolithiasis - Cholesterolosis - Rokitansky-Aschoff sinuses - Postcholecystectomy syndrome Bile duct/ other biliary tree Cholangitis (PSC, Ascending) - Cholestasis/Mirizzi's syndrome - Biliary fistula - Haemobilia - Gallstones/Cholelithiasis common bile duct (Choledocholithiasis, Biliary dyskinesia) Pancreatic Pancreatitis (Acute, Chronic, Hereditary) - Pancreatic pseudocyst - Exocrine pancreatic insufficiency - Pancreatic fistula Hernia Diaphragmatic: Congenital diaphragmatic - Hiatus Abdominal hernia: Inguinal (Indirect, Direct) - Umbilical - Incisional - Femoral Obturator hernia - Spigelian hernia Peritoneal Peritonitis (Spontaneous bacterial peritonitis) - Hemoperitoneum - Pneumoperitoneum GI bleeding Upper (Hematemesis, Melena) - Lower (Hematochezia) See also congenital, neoplasia

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