Liver AbscessProf. Ygber González de la Cruz, MD. MsCDepartment of Medicine and Therapeutic. SMAHS-UTG
• A liver abscess is a pus-filled mass  inside or attached to the liver. Common  causes are an abdominal infection such  a...
Liver Abscess• Relative rare location• Described by Hippocrates (400 b.c)• First published review by Bright (1936)• Propos...
Liver AbscessPyogenic Abscess Amebic Abscess Fungal Abscess
Liver Abscess• Liver invasion by  bacteria:  – Ascending infection in    the biliary tract    (ascending cholangitis)  – V...
Clinical FeaturesSymptoms• Pain Right Hypochondrium referred to  Right shoulder• Pyrexia (39º C)• Profuse sweating and Rig...
Clinical FeaturesSigns• Palor• Tenderness and rigidity in right  hypochondrium• Palpable Liver• Intercostal Tenderness• Ba...
Lab studies•   FBC•   LFT•   Blood cultures•   Abscess fluid culture•   Stools microscopy•   Serology
Imaging studies•   Sonar scanning•   CT scan w/ contrast•   Gallium and technetium scanning•   CxR
• Antimicrobial treatment is a common adjunct  to percutaneous or surgical drainage• Surgical drainage was the standard of...
• Antibiotic therapy as a sole treatment modality is not  routinely advocated, though it has been successful in  a few rep...
Medical treatment• Pyogenic AbscessBetalactam/betalactamase inhibitor plusMetronidazol or Clyndamicine• Amebic AbscessMetr...
Upcoming SlideShare
Loading in...5
×

Abceso hepatico

585
-1

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
585
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
26
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Abceso hepatico

  1. 1. Liver AbscessProf. Ygber González de la Cruz, MD. MsCDepartment of Medicine and Therapeutic. SMAHS-UTG
  2. 2. • A liver abscess is a pus-filled mass inside or attached to the liver. Common causes are an abdominal infection such as appendicitis or diverticulitis.
  3. 3. Liver Abscess• Relative rare location• Described by Hippocrates (400 b.c)• First published review by Bright (1936)• Proposal for surgical drainage by Ochsner. (1938)• Mortality went from 80 % to 5 %.
  4. 4. Liver AbscessPyogenic Abscess Amebic Abscess Fungal Abscess
  5. 5. Liver Abscess• Liver invasion by bacteria: – Ascending infection in the biliary tract (ascending cholangitis) – Vascular seeding (portal or arterial) – Direct invasion from a nearby source – Traumatic implantation
  6. 6. Clinical FeaturesSymptoms• Pain Right Hypochondrium referred to Right shoulder• Pyrexia (39º C)• Profuse sweating and Rigors• Loss of Weight• Earthy Complexion
  7. 7. Clinical FeaturesSigns• Palor• Tenderness and rigidity in right hypochondrium• Palpable Liver• Intercostal Tenderness• Basal Lung Signs
  8. 8. Lab studies• FBC• LFT• Blood cultures• Abscess fluid culture• Stools microscopy• Serology
  9. 9. Imaging studies• Sonar scanning• CT scan w/ contrast• Gallium and technetium scanning• CxR
  10. 10. • Antimicrobial treatment is a common adjunct to percutaneous or surgical drainage• Surgical drainage was the standard of care until the introduction of percutaneous drainage techniques in the mid 1970s. With the refinement of image-guided techniques, percutaneous drainage and aspiration have become the standard of care
  11. 11. • Antibiotic therapy as a sole treatment modality is not routinely advocated, though it has been successful in a few reported cases. – It may be the only alternative in patients too ill to undergo invasive procedures or in those with multiple abscesses not amenable to percutaneous or surgical drainage.• In these instances, patients are likely to require many months of antimicrobial therapy with serial imaging and close monitoring for associated complications
  12. 12. Medical treatment• Pyogenic AbscessBetalactam/betalactamase inhibitor plusMetronidazol or Clyndamicine• Amebic AbscessMetronidazol• Fungal AbscessAmphotericin B or Fluconazol
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×