2. Abscesses of the liver are relatively rare
Mortality rates decreased to 5-30%
• New radiologic techniques
• Improvement in microbiologic identification
• Advancement of drainage techniques
• Improved antibiotics
• Improved supportive care
3. No sex predilection
Age – mostly children and elderly
Risk more in:-
• DM
• Liver transplants
• Immunosuppressed
Mortality ranges from 5 – 30%
4. Pyogenic abscess
• Polymicrobial
• Most common cause
Amoebic abscess (Entamoeba histolytica)
Fungal abscess (Candida species)
5.
6.
7. MC symptoms :-
• Fever (either continuous or spiking)
• Chills
• Right upper quadrant pain
• Anorexia
• Malaise
8. Cough or hiccoughs (diaphragmatic
irritation)
Referred pain to the right shoulder
Insidious course (weight loss, anemia)
• ?? malignancy
Fever of unknown origin
Acute systemic toxicity (Multiple
abscesses)
Afebrile
14. Drainage - percutaneous /surgical
Antimicrobial treatment as adjunct
Antibiotic therapy as standalone
• Unfit for invasive procedures
• Multiple abscesses
• Many months therapy
• Serial imaging and close monitoring
15. Indications :-
• Signs of peritonitis
• Known abdominal surgical pathology (eg -
diverticular abscess)
• Failure of previous drainage attempts
• Complicated, multiloculated, thick-walled abscess
with viscous pus