Liver Abscess

Question 1

Definition and aetiology

Answer 1

Definition: localised collection of pus in liver parenchyma
Aetiology
~ Entamoeba histolytica
~ Echinococcus
~ pyogenic: E.coli, Klebsiella, staphylococcus
~ fungal: Candida

Question 2

Mode of infection

Answer 2

~ portal vein: from intra abdominal infections
~ Hepatic artery: septicaemia
~ ascending infection in biliary tract
~ direct invasion of liver from penetrating injury

Question 3

Morphology

Answer 3

Gross: filled with purulent debris, bacteria demonstrated with stains
~ Multiple or solitary, bacteraemia -small abscesses, trauma - large
~ common in right lobe
~10 cm

Question 4

Clinical Features

Answer 4

~ fever, right upper quadrant pain, tender hepato-megaly,jaundice

Question 5

Amoebic liver abscess

Answer 5

~ most common extra intestinal complication of amoebic dysentery
~Gross: 8-12 cm, well circumscribed, Subdiaphragmatic region
~ contains thick dark materials, anchovy sauce pus/ chocolate
Micro : Trophozoites

~ surgical drainage of large abscess
Complications
~ rupture in thoracic cavity - empyema/ lung abscess
~rupture in peritoneal cavity- peritonitis
~ invade blood-abscess of brain and lung