[Pyogenic-liver abscess: diagnosis and management]

Gastroenterol Clin Biol. 2008 Dec;32(12):1077-91. doi: 10.1016/j.gcb.2008.09.019. Epub 2008 Nov 18.
[Article in French]

Abstract

Pyogenic-liver abscesses are due to bacteria mostly from the portal and biliary tracts. There is usually only one located in the right liver, but they may be found in the left liver, be multiple or multilocular. Diagnosis, based on ultrasound and/or computed tomography scan, is confirmed by percutaneous-needle aspiration to identify the bacteria causing the disease. Global management includes the treatment of sepsis and the aetiology of the liver abscess: biliary lithiasis, diverticular disease, colon cancer, appendicitis or other intra-abdominal infections. However, no cause is found in 20% of cases. Treatment is based on antibiotics and, sometimes, percutaneous drainage while the cause may be treated immediately or later if the sepsis is controlled. Interventional radiology is often used. Surgery may be performed in case of failure of initial treatment and to cure the cause of the abscess. Prognosis may be poor, especially if there are associated-risk factors, such as diabetes and immunodepression, even though the outcome has improved with a multidisciplinary approach.

Publication types

  • English Abstract

MeSH terms

  • Decision Trees
  • Humans
  • Liver Abscess, Pyogenic / diagnosis*
  • Liver Abscess, Pyogenic / therapy*
  • Suppuration