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Published on: March 2, 2020
[Pyogenic-liver abscess: diagnosis and management]
L Chiche1, S Dargère, V Le Pennec
1Département de chirurgie viscérale et digestive, CHU de Caen, avenue de Côte-de-Nacre, 14000 Caen, France. chiche-l@chu-caen.fr
Gastroenterologie Clinique Et Biologique
|November 21, 2008
Summary
Pyogenic liver abscesses are bacterial infections. Diagnosis involves imaging and aspiration, with treatment including antibiotics and drainage, though causes remain unknown in some cases.
Area of Science:
- Hepatology
- Infectious Diseases
- Radiology
Context:
- Pyogenic liver abscesses (PLAs) are collections of pus in the liver, primarily caused by bacterial infections originating from the portal venous or biliary tracts.
- While typically solitary and located in the right lobe, PLAs can present as multiple, multilocular, or left-sided lesions.
Purpose:
- To outline the diagnostic modalities and management strategies for pyogenic liver abscesses.
- To emphasize the importance of identifying and treating the underlying etiology and managing sepsis associated with liver abscesses.
Summary:
- Diagnosis relies on imaging (ultrasound, CT) confirmed by percutaneous-needle aspiration for bacterial identification.
- Management encompasses antibiotic therapy, potential percutaneous drainage, and addressing the causative factors (e.g., cholelithiasis, diverticular disease, malignancy).
- Interventional radiology plays a key role, with surgery reserved for treatment failures or definitive etiological management.
Impact:
- Improved outcomes for pyogenic liver abscesses through a multidisciplinary approach, despite potential poor prognosis in patients with risk factors like diabetes or immunodepression.
- Highlights the evolving role of interventional radiology in the minimally invasive management of liver abscesses.
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