LIVER ABSCESS A liver abscess is defined as a pus-filled mass in the liver that can develop from injury to the liver or an intraabdominal infection disseminated from the portal circulation

1. LIVER ABSCESS

3. INTRODUCTION
• Liver abscess is more common in developing countries than in
developed countries
• Majority of them are parasitic infestations- Echinococcus and amoebic

5. CLINICAL FEATURES
• Pain in right upper quadrant
• Fever
• Tenderness
• Hepatomegaly
• Elevated liver enzyme
• Positive blood culture

10. ROUTE OF ENTRY TO LIVER
• Portal vein
• Arterial supply
• Ascending infections from biliary tree
• Direct infection of liver from nearby source
• Penetrating injury
• Cryptogenic

11. GROSS
• Single or multiple
• Small size in millimeters to massive size
• If single usually walled off by thick fibrous capsule

13. MICROSCOPY
• Neutrophilic abscess with areas of necrosis, inflammation, congestion
and proliferating fibroblast seen.

17. GROSS
• Solitary, often seen in right lobe
• Multiple abscess seen in advanced case
• Size of abscess vary
• Center of abscess has necrotizing material filled with reddish brown
thick pus resembling anchovy sauce

21. M/E
• Multiple neutrophilic abscess with areas of necrosis are seen in the liver
parenchyma.
• A rim of connective tissue, with few inflammatory cells and amoebic trophozoites
are clustered in the fibrin at the junction of viable and necrotic tissue.

22. M/E

23. THANK YOU