Gastroenterology Book

http://www.fpnotebook.com/

Liver Abscess

Aka: Liver Abscess, Hepatic Abscess
  1. Causes
    1. Amebiasis
    2. Bacterial Infection
      1. Aerobic Gram Negative Bacteria
      2. Streptococcus species
      3. Staphylococcus aureus
      4. Anaerobic Bacteria (Clostridium difficile)
      5. Syphilis (Treponema pallidum)
      6. NeisseriaGonorrhea
  2. Pathophysiology
    1. Sources
      1. Portal Vein infection
      2. Systemic bacteremia
      3. Ascending Cholangitis
      4. Direct extension
        1. Appendicitis
        2. Ruptured Peptic Ulcer
        3. Empyema
    2. Majority of abscesses are single
    3. Subacute onset over weeks
  3. Symptoms
    1. Fever
    2. Chills
    3. Nausea
    4. Anorexia
    5. Weight loss
    6. Right Upper Quadrant Abdominal Pain (50%)
      1. Pain may radiate to right Shoulder
  4. Signs
    1. Hepatomegaly
    2. Right upper quadrant tenderness
    3. Jaundice
  5. Labs
    1. Complete Blood Count (CBC)
      1. Anemia
      2. Leukocytosis
    2. Liver Function Test abnormalities
      1. Alkaline Phosphatase increased
      2. Aspartate Aminotransferase (AST) elevated
      3. Alanine Aminotransferase (ALT) elevated
    3. Blood Cultures (50% sensitive)
  6. Radiology
    1. Abdominal XRay
      1. Right diaphragm elevated
    2. CT Abdomen or RUQ Ultrasound
      1. Fluid filled Liver masses
  7. Management
    1. Empiric broad spectrum triple antibiotics
      1. Clindamycin or Metronidazole and
      2. Aminoglycoside and
      3. Consider Ampicillin
    2. Focus antibiotic coverage with Blood Culture results
    3. Surgery or percutaneous drainage

You are currently viewing the original 'fpnotebook.com\legacy' version of this website. Internet Explorer 8.0 and older will automatically be redirected to this legacy version.

If you are using a modern web browser, you may instead navigate to the newer desktop version of fpnotebook. Another, mobile version is also available which should function on both newer and older web browsers.

Please Contact Me as you run across problems with any of these versions on the website.

Navigation Tree