liver abscess

What is a liver abscess

A liver abscess is a cyst filled with pus. Liver abscess can occur in anyone. By itself, it is not life-threatening, as the pus is encapsulated and separated from all tissues. But it can become dangerous if the capsule opens and the contents leak out. It can happen suddenly, so you should always check with your doctor.

If a liver abscess is found early, it is usually treatable. Without treatment, it can burst and spread the infection, leading to sepsis, a life-threatening bacterial blood infection.

Causes of liver abscess in adults

There are two main reasons that can provoke a liver abscess.

Infectious:

• bacterial infection in the biliary tract;
• bacterial infections of the abdominal cavity associated with appendicitis, diverticulitis, or intestinal perforation;
• bloodstream infections;
• Entamoeba histolytica infection (an organism that also causes amoebic dysentery – it can be transmitted through water or person-to-person contact).

Traumatic:

• endoscopy of the bile ducts and ducts;
• blows, accidents;
• fall of life.

There are also factors that increase the risk of developing a liver abscess:

• Crohn’s disease;
• diabetes;
• elderly age;
• alcohol;
• impaired immune system due to conditions such as HIV or AIDS, as well as other immunodeficiencies, corticosteroid use, organ transplants, or cancer treatment;
• poor nutrition;
• travel to regions where amoebic infections are common.

Symptoms of a liver abscess in adults

The key manifestations of a liver abscess and complaints with it vary, but most often include a combination of symptoms:

• abdominal pain (especially in the right upper abdomen or under the ribs);
• clay-colored or gray, discolored feces;
• dark urine;
• yellowing of the skin and whites of the eyes (jaundice);
• diarrhea;
• fever or chills;
• joint pain;
• nausea with or without vomiting;
• loss of appetite;
• unexplained weight loss;
• malaise or lethargy;
• sweating.

In some cases, a liver abscess can be very life-threatening. Call XNUMX immediately if the patient has any of these symptoms:

• sudden change in behavior, such as confusion, delirium, lethargy, hallucinations, and lightheadedness;
• high temperature (above 38 ° C);
• agitation or lethargy;
• rapid heartbeat (tachycardia);
• breathing problems such as shortness of breath, trouble or inability to breathe, wheezing or choking;
• strong pain;
• vomiting.

Treatment of a liver abscess in adults

The diagnosis is confirmed if there are cystic or hard areas in the liver, from which purulent fluid with positive cultures is released when the contents are taken. It is important to get these tests quickly and start treatment because of the high risk of complications.

Diagnostics

After examining and collecting an anamnesis about how the patient fell ill, a number of tests need to be done. First of all, this is a general blood test – serum enzymes showing liver function (alkaline phosphatase, ALT, AST), blood cultures, prothrombin time and activated partial thromboplastin time, a serum test for antibodies to Entamoeba histolytica,

In addition, stool analysis for Entamoeba histolytica antigen will be taken and antigen or polymerase chain reaction (PCR) testing of the aspirated abscess fluid will be performed.

They also do liver ultrasound and computed tomography.

Modern treatments

Liver abscess is treated with both drugs and surgery.

Antibiotics. Various antibiotics are used to treat a liver abscess. Their choice depends on the nature of the infection. Main drugs:

• aminoglycosides such as amikacin (Amikin) or gentamicin (Garamycin);
• clindamycin (Cleocin);
• piperacillin-tazobactam combination (Zosin);
• metronidazole (Flagyl).

If it is an amoebic abscess, after the infection is cured, the patient will be prescribed another drug to kill the amoeba in the intestines to prevent the abscess from recurring.

surgical methods. They are different, and the choice depends on the degree of liver damage and the severity of the patient’s condition:

• aspiration – in this case, the pus is pumped out with a needle through the abdominal cavity, it happens several times (for abscesses less than 5 cm in diameter);
• drainage – it requires the installation of a catheter to drain pus (for an abscess more than 5 cm in diameter).

Both of these procedures are laparoscopic, done through small incisions. But sometimes open surgery is needed for peritonitis, thick-walled abscesses, ruptured abscesses, multiple large abscesses, and previously failed drainage procedures.

Prevention of liver abscess in adults at home

It is not always possible to avoid a liver abscess. However, in many cases, you can reduce the risk of developing pathology by avoiding the consumption of contaminated food or water, limiting travel to regions where amoebic infections are common.

Popular questions and answers

Answered our questions about liver abscess gastroenterologist, hepatologist, nutritionist Natalya Zavarzina.