Liver abscess is a disease that occurs as a result of purulent inflammation of the liver tissue, their death and the formation of a cavity filled with pus.
Purulent-destructive formation can be single or multiple. In the diffuse form, multiple ulcers are formed, as a rule, rather small. Single - larger, sometimes there are two or three abscesses.
In most cases, liver abscess develops as a secondary disease, often in middle-aged and older people. The prognosis of the course of the disease is always very serious and the complete recovery of the patient depends on a number of concomitant pathology factors.
Causes of liver abscess
What it is? The cause of liver abscess may be bacteria and parasites (amoeba). Depending on the route of infection, these forms of liver abscesses are distinguished:
- hematogenous - the infection spreads through the bloodstream through the vessels of the body;
- cholangiogenic - the infection enters the liver cells from the biliary tract;
- contact and post-traumatic - occur after open and closed abdominal injuries;
- cryptogenic - the source of infection is not installed.
Liver abscess occurs as a complication after dysentery, purulent infection of the body, purulent cholangitis and pylephlebitis. Injuries and intoxications that violate the functions of the liver can also lead to abscesses.
Common causes include perforated appendicitis and inflammation of the biliary tract, cholelithiasis and its complications, tumors of the pancreatic head or bile ducts, penetration of the parasites into the lumen of the bile ducts.
Symptoms of liver abscess
Signs of this disease are often atypical, that is, the overall clinical picture may resemble any of the serious diseases of internal organs:
- heart disease, etc.
A liver abscess develops slowly, and symptoms also appear slowly. Due to the development of an internal inflammatory process, body temperature is constantly increased. It may be accompanied by a shaking chill, fever and sweating.
There is a weakness, nausea, and sometimes vomiting, the patient loses his appetite, and the body weight decreases. In the right hypochondrium there are constant, dull pains, radiating to the lower back, right scapular region and shoulder. They are preceded by a feeling of heaviness in the right hypochondrium. During percussion, an increase in the size of the liver is found, and on palpation, its increased pain is noted.
Weight loss is often the only complaint in the early stages of an abscess, and therefore diagnosis in the early stages is difficult. In the later stages, the mucous and skin yellowness appears. When compression of the vessels of the liver or their thrombosis due to the inflammatory process may appear ascites (accumulation of fluid in the abdominal cavity).
The main feature of liver abscesses is that the clinic is often masked by the underlying disease, against which an abscess has developed, therefore a long time often passes from the beginning of the formation of the pathological process to its diagnosis.
At the initial stages of development in the organ of purulent cavities, their identification is difficult. The doctor may suggest a pathology when clarifying complaints, when examining a patient.
From diagnostic examinations prescribe:
- General blood analysis.
- X-ray examination.
- Ultrasound examination (ultrasound) of the liver.
- Spiral computed tomography (CT).
- Magnetic resonance imaging (MRI).
- Fine Needle Aspiration Biopsy (PTAB).
- Radioisotope scanning of the liver.
In the most difficult cases, resort to diagnostic laparoscopy. At the same time, a special video tool is introduced into the abdominal cavity, which allows examining the organs, determining the diagnosis and, if possible, draining the abscess.
How to treat liver abscess
Depending on the cause of liver abscess, as well as the severity of symptoms of the disease, a treatment regimen is determined.
Liver abscess therapy is carried out by conservative and surgical methods. In case of bacterial forms, depending on the type of pathogen, antibiotics are obligatory, and in amoebic forms, anti-amymetic drugs.
Single abscesses are drained under the control of ultrasound, this stage of treatment is necessary for the release of pus. Multiple treat conservatively. Extensive surgery is resorted to when the abscess is located in hard-to-reach places and, if necessary, surgical treatment of the underlying disease. To create a high therapeutic concentration of the antibiotic in the tissues of an organ, the medicine is often administered through the hepatic vein, and a catheter is inserted into it beforehand.
All patients with a postponed abscess are prescribed a special diet No. 5, rehabilitation therapy. Be sure to conduct appropriate treatment of the disease that led to the formation of an abscess. Patients of this profile are observed jointly by a gastroenterologist and a surgeon. If necessary, the infectious diseases are involved.
The prognosis depends on the form of liver abscess, the severity of the symptoms and the effectiveness of the treatment. In the case of a single liver abscess, with timely measures taken, the prognosis can be favorable. About 90% of patients recover, although the treatment is very long. With multiple small abscesses or the absence of treatment of a single abscess, death is very likely.