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LIVE$I' ABSCi:.

;:l
r CIRCUIJSCRIBED, o: tl.n encat'-( !.
inflamriqation wit:i :; -c.'csi!; cl
parenchinla cauL{,i :r)i inuiiilr| ir
pathogiils (bact,-,, ;. i)i()tozu.). il
ABSES HATI and fungi.
r Solitary or multipil
r Micro-abscesses: r!iiiusely aftt:cti;r.;,,rc
entire liver (some tirrie as the outc(,nr,. ()i
purulent. suppurati rJ cholangrrrs.

*
rt:
g
j'
ii:} ,.*.

Route of infec: ion


r Hematogenic
r Blllary
> Percontinuitatem
r Post traunratic
> Post opci'ative

l
I

Type of liver abscess according to


aetiology CLINICAL FINDING
:

) Bacterial abscess ) Bursts of r RUQ abd pain


r Protozoal abscess perspiration radiation to riglri
r Helminth abscess r Night sweat shoulder
> Fungal abscess r Lack of appetite r'Occasiorr;il
r Lost of weight respirliorv pain
) Nausea r Dry itiirr;lt
r Weakness r.Enlarrir:ri "rncl
r Gerreral malaise tender iivt,r
IMACING
) USC ) method of choice (sesitivity 7l-92%
for foci > I ,5 cm)
r CT Scan
> X ray examination
-ii4
*1
;ftr
"s
d
v&

F
I
!Lj
LABCT|{ATOii';'
r SICN OF INFECI-!iJN ) SlCli iil: i iVt l':
" Canqes in bloori DISi AlT
couilt (leucolvtc:; ,
" (,i ) i ,.:(,P !

left si;ift, anemi.,l " (;( , I i;;. l.l'i


" BSR/" CRt Pltos;ti:.rl,r..r'
. Fibrinogen, LDii ,.St'; trtn !-itir.r tr[;,;; .
" Serunr iron, i "(lli..)irr(t:v.jrt'
..litlt' rr idr
PERCUTAN EOUS AS PI RATION

' ,,'INITIATE tF AB fail ) Antibiotics


- r cjiV5 con iinucd
' ,,iqe abscess )
.,-:iriai measure
COMPLICATIOf,I :

r Secondary Infuction r

I Anatomcal varlalion * H*nrorthlqe

r Abscess forrnatiorr et thttlte of ;l1t)tt.rti,)r1

.:
Secondary lnfection
r Aspiration of amoebic abscess (often
endogenous)
) Rupture to the lung, vlscus, etc
) lf patient remain toxic qnd fever does not
settle down after vigorous therapy )
secondary infection should be suspected
r lf aspiration repeated + the pus usually
thinner, yellowish and have an odour ) gram
stained to see the organism
) When such compiir:rtign occur vitJorous
treatment with sf;:cific afltibiritit lrlrtt.r.r. ':y
cu ltu re and sensit!\'! ty.testf .siroLl ir.i i,r::
administered in r:i .;ition to.ar'lrr,',,;r: iai
therapy. Aspiration will greatiy ;rid reco',,eiy.
I lf the patient sho\,r5 nci improve:n(nt or tllc
pus aspirated at c .ah Seasoh: ,;,1'.r,r ilt)[
diminish ) oper. i: ,inage n,.. i',
consider€d.
HAEMORRHAGE
) Coutd occur during or after procedure
r Could be associated with tear of the liver
substance
r Asossiated with
. intra hepatic hematoma peritonitis
. Pleural effusion
. Pneumothorax
. Death due to vagal shock
) ) blood transfusion
) ) Preparation fo: laParatomi