Liver abscesses Flashcards Preview

Liver > Liver abscesses > Flashcards

Flashcards in Liver abscesses Deck (13):
1

What are abscesses?

A swollen area within body tissue, made up of an accumulation of pus

2

What causes liver abscesses?

Infection:
- bacteria
- amoebic
- hydatid (a type of tapeworm)

3

What bacteria often cause liver abscesses?

E. coli most commonly
Streptococcus species
Staphylococcus species
Bacteroides species

4

How do bacteria get to the liver and cause an abscess?

By haematogenous spread from an infection elsewhere, usually the gut

Infection in the gut, diverticulitis or appendicitis for example spread to the liver via the portal vein

5

Are liver abscesses mostly mono or polymicrobial?

Polymicrobial

6

Name the amoeba that causes amoebic liver abscess?

Entamoeba histolytica

7

Where does Entamoeba histolytica come from and how does it get to the liver?

Found in water and food

Ingested, ends up in the gut

Gets to liver via the portal venous system

8

Where in the liver do you mostly find amoebic liver abscesses?

Right lobe

9

Clinical features of liver abscesses?

Fever
Weight loss
Abdominal pain
Tenderness in RUQ

Right side pleural effusion

10

Investigation of liver abscesses?

Bloods:
- raised white cell
- cultures of pathogen
- raised ESR
- raised alkaline phosphatase, impaired liver function


USS:
- single or multiple round lesions

CT:
- define the lesions as abscesses, rim of inflammation around lesion characteristic of abscess

Serology:
- to distinguish amoebic from bacterial

History:
- travel to endemic areas?
- any GI symptoms?

11

Management of an amoebic liver abscess?

Metronidazole orally for 10 days
No need to aspirate

12

Management of a bacterial liver abscess?

Aspiration: percutaneous and using fluoroscopy

Put catheter in for drainage

Antibiotics chosen from cultures taken during aspiration

13

What does the portal vein do?

Coveys blood from gut, pancreas, stomach to the liver