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A liver abscess is a sharply delimited reservoir containing necrotic tissue, i.e. pus. It is a focal lesion of the liver, most often resulting from a bacterial, amoebic or fungal infection. What are the symptoms of a liver abscess? How is the treatment going?
Liver abscess(Latinabscessus hepatis ) most often occurs on a bacterial, sometimes parasitic basis, and in very rare cases it can develop as a result of fungal infection. Bacteria that can cause liver abscess formation include streptococci, enterococci, bacteriaEscherichia coli ,Staphylococcus ,Klebsiellawhether anaerobic bacteria. Liver infection can occur through the bile ducts, arterial or portal vessels, for example in diverticulitis, appendicitis or inflammatory bowel diseases, as well as through continuity from the peritoneum or adjacent organs.
It has been shown that some people may be more predisposed to developing liver abscesses. This applies to patients who have had bowel surgery in the past, suffer from diabetes, who abuse alcohol or are immunocompromised. In many cases, it is not possible to establish the cause of the abscess, then we talk about the so-called cryptogenic liver abscess.
Liver abscess: symptoms
Liver abscess is often acute and severe. You may experience high fever (39-40oC), chills, sweating, and poor general condition. Sick people may complain about
- stomach ache
- nausea
- vomiting
- weakness
- weight loss
Jaundice in some cases may be the only manifestation of the disease. Physical examination may show enlargement of the liver and pain in the right upper abdominal quadrant, but it is estimated that only about half of the patients are affected by such symptoms. Occasionally, a liver abscess can rupture and "spread" onto the surrounding tissues. The dangerous consequence is the penetration of the abscess into the chest and the formation of a hepatobronchial fistula, which fortunately is rare.
How is a liver abscess diagnosed?
The signs and symptoms of a liver abscess play a key role. In addition to the deviations in the clinical trial mentioned above,laboratory tests may reveal hypoalbuminaemia, elevated liver enzymes and leukocytosis.
Unfortunately, none of these tests is specific for liver abscess, so it is always necessary to exclude other disease entities that may proceed in a similar way. The X-ray examination shows the elevation and immobilization of the right side of the diaphragm, but the radiographic image is normal in 50% of patients. patients.
The most sensitive tests in diagnosing a liver abscess are ultrasound and computed tomography. Their increasing availability in even small treatment centers has significantly contributed to the reduction of the number of deaths due to liver abscesses, as they help to diagnose the disease very quickly and implement appropriate treatment in a short time. These tests often require confirmation by microbiological examination of the liver biopsy.
Liver abscess: treatment
Treatment of a liver abscess should consist of targeted antibiotic therapy, which is selected based on the antibiogram. In addition, in some cases, percutaneous abscess drainage is necessary. If the liver abscess exceeds five centimeters, surgical drainage after opening the abdominal cavity should be considered. However, the primary cause of the disease must always be controlled and treated first, otherwise treatment will only be symptomatic. A team of doctors should take part in the treatment of a liver abscess, because the coordinated action of many specialists gives the best treatment results.