3. Definition :
It is a pus filled mass in the liver that can develop from injury to the
Liver.
It is collection of pus in liver in response to an Intestinal parasite
Entamoeba histolytica.
4.
5. Etiology :
• Infection – major bacterias that cause liver abscess are :
Streptococcus group, staphylococcus species, Escherichia species,
klebsiella species, Pseudomonas, proteus, entamoeba Histolytica.
In many cases, it was found polymicrobial.
• Metastasis such as primary liver tumors
• Biliary injuries (procedures)
• Biliary tract disease
• Appendicitis
• Diverticulitis
6. Pathophysiology :
Due to etiology
Infecting organisms reach liver through biliary system
Bacterial toxin destroy neighboring liver cells results in necrosis
Leukocytes migrate into infected area
They results in abscess cavity filling with liquid full of living & dead
leukocytes, liquefied liver cells & bacteria
Abscess cavity may be single or multiple.
7. Clinical Features:
Fever with chills & diaphoresis
Malaise
Anorexia
Nausea & vomiting
Abdominal pain with tenderness in right upper quadrant
Jaundice
Hepatomegaly
Anemia
Unintentional weight loss
8. Diagnostic studies :
History collection & physical examination
CBC
Liver Function Test
Blood culture
Aspiration of abscess guided by ultrasound
CT or MRI
Liver Biopsy
9. Management :
It includes
IV Antibiotics. Specific antibiotic will be decided after identifying
bacteria. Common drugs used are
- Metronidazole
- Third generation cephalosporin / Quinolones
- Β Lactum antibiotics
- Aminoglycosides
Percutaneous drainage of abscess
Open surgical drainage (if percutaneous drainage is ineffective)
10. Nursing management :
It depends on patient’s physical status and medical management.
- Monitor vital signs
- Observe closely for changes in behaviour
- Reporting about signs & symptoms to physician
- Administration of IV antibiotics
- Instructing patient and family members about discharge instructions.
