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Results for “Liver Abscess, Pyogenic”

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PubMed1984

Experience with liver abscess.

One hundred ninety-two liver abscesses in 190 patients were treated: 109 by needle aspiration, and 83 by operation. Mortality and complication rates were lower in the aspiration group, and the average hospital stay was shorter. This was true for both pyogenic and sterile abscesses, the latter being presumed to be amebic, although trophozoites were recovered from liver pus in only two patients. Patients with pyogenic abscess were, on the average, considerably younger than patients with the condition in the United States for reasons that are not immediately apparent. The preponderance of amebic abscesses found in men is less than usual, again for reasons that are not clear. Both pyogenic and amebic abscesses were commonly associated with fever, chills, and tenderness and pain in the right upper abdomen and hepatomegaly on physical examination. We found metronidazole effective in the treatment of both pyogenic and amebic abscesses.

Adult↗
PubMed2006

Imaging of hepatic infections.

Imaging plays a significant role in the detection, characterization and treatment of hepatic infections. Infectious diseases of the liver include pyogenic and amoebic abscesses and parasitic, fungal, viral and granulomatous infections. With increases in worldwide travel, immunosuppression and changing population demographics, identification of cases of hepatic infection is becoming more common in daily practice. Knowledge of the imaging features seen with hepatic infections can assist in early diagnosis and timely initiation of appropriate therapy. This review presents the imaging appearances of hepatic infections, emphasizing specific features that may contribute to the diagnosis. Examples of the imaging findings seen with pyogenic and amoebic abscesses, infection with Echinococcus granulosus (Hydatid), schistosomiasis, candidiasis and tuberculosis (TB) are presented.

Diagnosis, Differential↗
PubMed1990

[Solitary hepatic cysts--a therapeutic problem].

The authors give an account of the therapeutic procedure in 22 patients with solitary cysts of the right liver lobe. In 13 pyogenic cysts (abscesses) drainage of the abscess was made under CT control, in four cysts anatomical or non-anatomical resection of the liver was performed, in three cysts enucleation, in one biliary cyst cystojejunostomy with a Roux-Y loop of the jejunum. Aetiopathogenesis of the cysts: pyogenic cysts 14, echinococcal cysts 2, inborn parenchymatous cysts 3, posttraumatic cysts 3.

Adult↗
PubMedDate not supplied

[Liver abscess. Imaging and interventional radiology in French Polynesia].

23 cases of liver abscess are reported (13 pyogenous, 10 amoebic). Clinical feature is rather uniform and evocative; thanks to picture technics, diagnosis was easy in 22 cases but hesitating in one case. Semeiology revealed by scanner or echography is detailed. Both techniques are fairly equivalent considering accuracy but not really specific. The interventional radiology at the stage of diagnosis, consists in puncture (14 out of 23 cases), at the stage of therapy, in transcutaneous drainage (6/23 cases). They are performed with the assistance of scanner, echoscopy and/or radioscopy. Therapy has been medical in 13 cases/23, associated with transcutaneous drainage 6 times, surgical in 4 cases. A procedure is proposed, including early puncture to diagnose, drainage of pyogenous abscesses, only medical treatment against amoebiasis exceptionally help of surgery and controlled by echography.

Adolescent↗
PubMedDate not supplied

Liver abscess due to clostridium septicum. A case report and review of the literature.

The onset of liver abscess due to Clostridium septicum -an anaerobic gram-positive bacillus- is a rare condition, generally arising in cancer patients. The radiological picture is that of gas-containing pyogenic abscess, that predominates within preexisting liver metastases. We report a case of a 50-year-old patient with metastatic colon cancer who was referred with multiple Clostridium septicum liver abscesses. The patient underwent parenteral antibiotherapy as well as transcutaneous drainage of the largest liver abscess. However the outcome was unfavorable in a clinical picture of liver failure that was likely due to disease progression rather than sepsis. Clostridium septicum liver abscess is a life-threatening condition that occurs in fragile patients, mostly with metastatic cancers. A review of the reported cases is presented and treatment options are discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

Septicaemia associated with an Aerococcus viridans infection in immunodeficient mice.

This report describes a case series of septicaemia caused by infection with Aerococcus viridans in immunodeficient NOD/LtSz-Prkdc(scid) (NOD/SCID) mice. During a period of 3 weeks more than 40 animals died or became ill with clinical signs of ruffled coat, weight loss, laboured breeding, and distended abdomen. At necropsy it was found that the animals displayed symptoms of sepsis with widespread abscesses in the liver, heart, lungs or pyogenic peritonitis. A Gram-positive coccus was isolated in pure culture from the abscesses or peritoneum from affected animals. According to phenotypic and phylogenetic characterization, the isolate was identified as A. viridans. This is the first report of a spontaneous outbreak of septicaemia caused by A. viridans infection in immunodeficient laboratory mice and we conclude that A. viridans should be considered as a pathogen in immunodeficient mice.

Animals↗
PubMed1992

Diagnostic imaging of liver abscess.

This article on imaging of liver abscess discusses the appearance of pyogenic, amebic, and fungal abscesses using a multimodality approach, as well as imaging-pathologic correlation. It summarizes the experience obtained reviewing 100 cases of hepatic abscesses from two geographical areas that have different incidences of etiologic factors. Sixty abscesses were collected at the Hospital General de Mexico, where there is a high incidence of amebic abscesses, and 40 cases were collected at the University of Florida College of Medicine, Gainesville, Florida, where pyogenic and fungal abscesses predominate. This article includes sections on pathology, etiology, epidemiology, clinical findings, prognosis, and therapy of hepatic abscesses, as well as imaging findings. Imaging is divided by techniques, including plain films, nuclear medicine, ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and angiography. It also includes a differential diagnosis section where different imaging findings of cystic lesions of the liver other than abscesses are displayed. Thirty-three references from both U.S. and Mexican authors are included, as well as 20 illustrations. In summary, in this article, we demonstrate how imaging is useful in diagnosing hepatic abscesses and how a focal mass in the liver may be distinguished between an abscess and a necrotic tumor. A practical approach is used so radiologists can benefit from the authors' experience and apply the findings described in their daily practice.

Diagnostic Imaging↗
PubMed1994

Computed tomography and ultrasound in the diagnosis and treatment of liver abscesses.

Liver abscess remains a serious and even life-threatening condition, despite advances in imaging and treatment. The diagnosis of liver abscess depends heavily on radiologic imaging, particularly ultrasound (US) and computed tomography (CT) scanning. The appearance of liver abscesses on these modalities depends mainly on the chronicity of the abscess. The US and CT features of 33 patients with liver abscesses are presented. Percutaneous drainage of pyogenic abscesses under imaging control is the treatment of choice. Eleven of 24 patients with pyogenic abscesses had percutaneous drainage with good results.

Adult↗
PubMed1993

Fulminant herpes hepatitis mimicking hepatic abscesses.

Fulminant hepatitis due to herpes simplex virus (HSV) in adults is a rare and deadly disease. We describe a 23-year-old woman with a 20-year history of Crohn's disease (CD) who was hospitalized with an acute febrile illness and diarrhea. A computed tomography (CT) scan of the abdomen demonstrated an intramural sigmoid colon abscess and multiple abscesses in the liver. Despite high-dose parenteral corticosteroids and broad-spectrum antibiotics, the patient remained acutely ill, with high fever and markedly elevated serum transaminase levels, but no jaundice. Sigmoid resection and wedge liver biopsy were performed at laparotomy. Histologic examination documented HSV-type intranuclear inclusions and inflammation with necrosis in both the sigmoid colon and liver specimens. The patient subsequently died despite parenteral acyclovir treatment. Although rare, fulminant hepatitis due to HSV simplex virus should be considered in the differential diagnosis of all patients with severe hepatitis. Of special note, the necrotizing liver lesions may be mistaken for pyogenic abscesses on CT scan.

Adult↗
PubMed1975

67Gallium accumulation in hepatic actinomycosis.

A case of actinomycosis involving the liver is reported. The liver scan with 99mTcS colloid showed multiple areas of focal abnormalities. 67Gallium citrate liver scan showed these areas to concentrate intensely. This pattern of differential hepatic scintigraphy is seen in pyogenic abscesses as well as malignancy of the liver. Actinomycosis may mimic the clinical picture of a malignant neoplastic process, making the differential diagnosis of 67Ga-positive lesions of the liver more difficult.

Actinomycosis↗
PubMed2003

Complications after interventional sonography of focal liver lesions: a 22-year single-center experience.

OBJECTIVE: To analyze the complications of diagnostic and therapeutic sonographically guided interventional procedures of focal liver lesions observed during a 22-year period in a single center. METHODS: Complications of sonographically guided diagnostic and therapeutic procedures on focal liver lesions, observed during a 22-year period in a single center, were reviewed. From 1979 to 2001, 13,222 patients (age range, 7-89 years; mean, 59 years; 8,688 male and 4,534 female) with 13,777 focal liver lesions underwent 16,648 sonographically guided biopsies and 3,035 therapeutic procedures: pyogenic and amebic abscess aspiration, ethanol injection of hydatid liver cysts, and percutaneous ablative treatments (ethanol injection in either multiple or one-shot sessions, radio frequency ablation, and interstitial laser photocoagulation) of primary and secondary liver tumors. RESULTS: The overall mortality was 0.06%. No death or major complication occurred after diagnostic procedures and liver abscess drainage. In the therapeutic group mortality was 0.6%: 1 patient died of anaphylactic shock during treatment of a hydatid cyst; 7 patients died after liver tumor ablation with ethanol injection (6 after one-shot treatments and 1 after multisession treatments). Major complications after liver tumor ablative procedures included 10 cases of acute liver failure, 2 cases of acute tubular necrosis, 2 cases of self-limiting hemoperitoneum, 2 cases of paralytic ileum, 2 abscesses, and 1 case of cholangitis. One case of a biliary cyst fistula and 1 case of intracystic hemorrhage occurred after treatment of hydatid liver cysts. CONCLUSIONS: Sonographically guided diagnostic biopsy of focal liver lesions and liver abscess drainage are safe procedures. In contrast, liver tumor ablation procedures have a low but definite risk of mortality and major complications. Puncture of hydatid cysts must be performed only in institutions that can treat anaphylactic shock.

Biopsy, Needle↗
PubMed2006

Endoscopic management of liver abscesses and cysts that communicate with intrahepatic bile ducts.

BACKGROUND AND STUDY AIMS: The formation of a communication between liver abscesses or cysts and intrahepatic bile ducts is an uncommon cause of significant bile leak. Surgical management of biliary fistulas is associated with high morbidity and mortality. We performed a prospective study of endoscopic management of this type of biliary fistula. PATIENTS AND METHODS: We studied 26 patients who had either liver abscesses or hepatic cysts that had ruptured into the intrahepatic bile ducts. The presence of a biliary fistula was suspected by jaundice and/or by the appearance of bile in percutaneous drainage effluent from a liver abscess and was confirmed by endoscopic retrograde cholangiopancreatography. Once the route of the fistula between the liver abscess or cyst and the intrahepatic bile duct had been defined by cholangiography, patients underwent treatment by sphincterotomy, and either biliary stenting or nasobiliary drainage. Nasobiliary drains or biliary stents (both 7 Fr) were placed according to standard techniques. Nasobiliary drains were removed when bile leakage stopped and closure of the fistula was confirmed by cholangiography; stents were removed after an interval of 4-6 weeks. RESULTS: Of a total of 525 patients with hepatic abscesses or cysts who were seen over a 5-year period, there were 26 patients who developed a demonstrable communication between liver abscesses (n = 20; 16 amebic, four pyogenic) or hydatid cysts (n = 6) and intrahepatic bile ducts (right intrahepatic bile ducts in 22 patients, left intrahepatic bile ducts in four patients). We performed either sphincterotomy with insertion of a nasobiliary drain (n = 20) or sphincterotomy with biliary stenting (n = 6). The fistulas healed in all patients after a mean time of 4 days (range 2-20 days) after endoscopic treatment. We were able to remove the nasobiliary drainage catheters and stents 6-34 days after their placement. CONCLUSIONS: In this case series, endoscopic therapy appears to be an effective mode of treatment for biliary fistulas complicating liver abscesses and cysts.

Adult↗
PubMedDate not supplied

Cystic focal liver lesions in the adult: differential CT and MR imaging features.

Cystic lesions of the liver in the adult can be classified as developmental, neoplastic, inflammatory, or miscellaneous. Although in some cases it is difficult to distinguish these entities with imaging criteria alone, certain cystic focal liver lesions have classic computed tomographic (CT) and magnetic resonance (MR) imaging features, which are important for the radiologist to understand and recognize. Lesions with such features include simple (bile duct) cyst, autosomal dominant polycystic liver disease, biliary hamartoma, Caroli disease, undifferentiated (embryonal) sarcoma, biliary cystadenoma and cystadenocarcinoma, cystic subtypes of primary liver neoplasms, cystic metastases, pyogenic and amebic abscesses, intrahepatic hydatid cyst, extrapancreatic pseudocyst, and intrahepatic hematoma and biloma. Specific CT and MR imaging findings that are important to recognize are the size of the lesion; the presence and thickness of a wall; the presence of septa, calcifications, or internal nodules; the enhancement pattern; the MR cholangiographic appearance; and the signal intensity spectrum. In addition, access to critical clinical information remains extremely important. The most important clinical parameters defined include age and gender, clinical history, and symptoms. An understanding of the classic CT and MR imaging appearances of cystic focal liver lesions will allow more definitive diagnosis and shorten the diagnostic work-up.

Cysts↗
PubMedDate not supplied

[Hepatic abscess].

The Authors review the medical records of 9 patients with liver abscess over a 15-year period from 1975 to 1989. They report on 5 pyogenic abscess, 3 amebic abscess and one case of tuberculosis of the liver. The most common initial diagnosis was fever of unknown origin, abdominal pain and hepatomegaly. The treatment consisted of 6 percutaneous transhepatic drainage, 2 open surgical drainage, and one explorative laparotomy (tbc infection). The Authors had no mortality and recommend the percutaneous transhepatic drainage as first-choice treatment.

Adult↗
PubMed1994

The changing clinical spectrum of liver abscess: the Jerusalem experience.

A retrospective study was conducted of all 31 patients with liver abscess admitted to Shaare Zedek Medical Center between 1979, the year computed tomographic scan and ultrasound were introduced, and 1992. Fever and abdominal pain were the most common symptoms. Duration of symptoms was short: 81% of patients had symptoms for < or = 5 days and none had symptoms for more than 3 weeks. Amoebic abscess was found in one patient only, the remainder were pyogenic. Biliary tract pathology remains the most common cause of liver abscess (39%). The diagnosis was made by ultrasound in 22/31 (71%) and by computed tomographic scan in 9/31 (29%) of patients. Treatment consisted of intravenous antibiotics and percutaneous drainage under ultrasound guidance in 24/31 patients (77%). Four patients died (13%), three of whom had underlying malignancies. Clinical features were compared with those from a similar series of 36 cases with liver abscess reported from Jerusalem predating ultrasound and computed tomographic scan (1967-1977). Several major changes have occurred. First, the relative incidence of amoebic abscess has dramatically decreased. Second, ultrasound and computed tomographic scan have facilitated earlier diagnosis and percutaneous drainage, contributing to improved survival and lower morbidity.

Adolescent↗
PubMed1998

Focal inflammatory disease of the liver.

Imaging and image-guided intervention have revolutionized management of hepatic inflammatory diseases. Pyogenic abscess is preferentially treated percutaneously. Radiologic techniques are crucial for the diagnosis of amebic liver abscess and infectious conditions of the liver in immunocompromised patients.

Echinococcosis, Hepatic↗