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Liver Diseases pp 231-237 | Cite as

Hepatic Abscesses

  • Bogdan Dorobanţu
Chapter

Abstract

Liver abscess is a purulent collection, single or multiple, developed intrahepatically mostly with bacterial aetiology (specific or nonspecific), fungal or amoebaean. Most common infection is represented by gastrointestinal flora (over 75%—Escherichia coli, Klebsiella pneumoniae), Staphylococcus aureus and group A streptococci. The incidence of anaerobic microorganisms is lower—the most common are Bacteroides fragilis, Fusobacterium spp. and Clostridium spp. In the case of pyogenic abscesses several mechanisms are involved as ascendant biliary contamination, haematogenous contamination, hepatic trauma, direct contamination and other mechanisms. Clinical diagnosis of liver abscesses is difficult because of nonspecific semiology, in many cases the only symptom being fever. Associated to fever one can register other nonspecific symptoms as well, such as fatigue, nausea, vomiting, abdominal pain, which dominate the clinical picture. Specific symptoms may appear depending on the pathogen. Radiological explorations are most important, and when it is possible the isolation of aetiological agent gives the positive diagnosis. First line of treatment is usually antibiotherapy associated with drainage (percutaneous—under ultrasound or CT guidance, and surgical drainage) or, in selected cases, liver resection. Mortality in case of hepatic abscesses is still important, but due to modern therapies has significantly decreased.

Keywords

Hepatic abscess Pyogenic abscess Amoebaean abscess Percutaneous/surgical drainage Liver resection 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Bogdan Dorobanţu
    • 1
    • 2
  1. 1.“Carol Davila” University of Medicine and PharmacyBucharestRomania
  2. 2.“Dan Setlacec” Centre for General Surgery and Liver TransplantationFundeni Clinical InstituteBucharestRomania

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