Liver Abscess Treatment (Pyogenic Hepatic Abscess)
Liver Abscess Cause:
bacteria invades liver via- Bile duct, Hepatic artery, Direct extends from infections, traumatic.
Risk factors- male sex, older age.
Predisposing factors- malignancy, inflammatory bowel disease, diabetes mellitus, cirrhosis, need for liver transplantation, proton pump inhibitors use, & endoscopic sphincterotomy.
Statin reduces risk of pyogenic liver abscess.
Abscess increased risk of hepatocellular carcinoma & gastrointestinal malignancy.
Acute cholangitis from- biliary obstruction by stone, neoplasm, & stricture, Cryptogenic (no cause), appendicitis or diverticulitis.
Organisms- E coli, Proteus vulgaris, Klebsiella pneumoniae, multiple microaerophilic , & anaerobic species, & Enterobacter aerogenes, (occasional Salmonella, Yersinia, Haemophilus, & Listeria), etc.
Hepatic candidiasis, actinomycosis, & tuberculosis seen in immunocompromised & hematologic malignancies.
Liver Abscess Symptoms & signs:
Fever, jaundice, right upper quadrant pain & tenderness.
Liver Abscess Investigations:
CBC- leukocytosis- shift to the left.
LFT- abnormal.
USG, CT, or MRI Abdomen- detect- Pyogenic Hepatic Abscess.
Liver Abscess Treatment
Intravenous ceftriaxone 2 g once a day plus
Intravenous metronidazole 500 mg every 6 hourly for 2-3 weeks, may extend up to 6 weeks.
If abscess >/=5 cm in diameter or slow response to antibiotic- intermittent needle aspiration, percutaneous / EUS guided catheter drainage / stent placement/ surgical ( laparoscopic) drainage.
Hepatic candidiasis often responds to intravenous amphotericin B (total dose of 2–9 g), Abscess may need drainage.
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Liver abcess treatment very nicely explained add with treatment part also thank you sir