Liver abscess is a local accumulation of pus in the thickness of the hepatic parenchyma caused by exposure to pathogenic microflora or parasites. The abscess in this case is always secondary, that is, it occurs against the background of some existing damage to the body, most often due to the infection by the current of blood. This disease is extremely difficult, therefore it is treated exclusively in a hospital environment, and in the absence of timely medical care can lead to death.
Causes of liver abscess
In medicine, liver abscesses are usually divided into pyogenic and amoebic.
Pyogenic liver abscess
This form of the disease is more common in people older than 35 years. The most common source of infection in this case are diseases of the biliary tract (cholangitis or acute cholecystitis). The second most frequent cause is various intraperitoneal infections:
- ulcerative colitis;
- Crohn's disease ;
- intestinal perforation;
- diverticulitis.
It is also possible to transfer the infection from closely located sources of infection or with general sepsis. In the latter case, Staphylococcus aureus and hemolytic streptococcus are often found. In addition, it is possible to develop an abscess with a liver injury and the onset of a hematoma, which then becomes inflamed, and if the liver is affected by worms. Defeats can be either single or multiple.
Amoebic liver abscess
Such an abscess develops due to the pathogenic action of amoeba (Entamaeba histolytica), which is introduced into the liver from the rectum and is a complication in acute or chronic amoebiasis of the intestine. This form of the disease is more often observed in young people and, as a rule, causes a single purulent formation.
Symptoms of liver abscess
The symptoms of this disease are often atypical, that is, the overall clinical picture can resemble any of the serious diseases of internal organs:
- pneumonia;
- pleurisy;
- heart disease, etc.
Usually, regardless of the type of disease, liver abscess is accompanied by fever and severe pain in the right hypochondrium. With the development of the disease, the liver increases in size, is painful on palpation, blood counts increase in the number of leukocytes, as well as a tendency to anemia .
Patients with general weakness, lack of appetite, often nausea and vomiting. More than half of the cases in the first days are marked by icteric sclera and mucous membranes, which eventually disappears. In patients with amoebic form, diarrhea with traces of blood can also occur.
Treatment of liver abscess
Liver abscess is an extremely serious disease with a high risk of death, which can be treated only in a hospital environment, as it implies mandatory surgical intervention.
Treatment is always complex and determined by the doctor, depending on the causes that caused the disease.
The most optimal for today is the use of antibiotic therapy in combination with percutaneous drainage of inflammation under the supervision of ultrasound. In the event that the drainage of the liver abscess is not effective, then a hollow operation is performed. With the amoebic form of the disease, surgery is not performed until the intestinal infection is eliminated.
In the case of a single liver abscess, with timely measures taken, the prognosis may be favorable. Recovers about 90% of patients, although the treatment is very long. Multiple or single, but not drained in time abscesses, almost always lead to death.