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Review
. 2014 Jan;5(1):60-67.
doi: 10.1136/flgastro-2013-100371. Epub 2013 Sep 3.

Pyogenic liver abscess

Gwilym James Webb  1 , Thomas Patrick Chapman  1 , Philip John Cadman  2 , David Angelo Gorard  1
Affiliations
Review

Pyogenic liver abscess

Gwilym James Webb et al. Frontline Gastroenterol. 2014 Jan.

Abstract

Pyogenic liver abscess has a variable clinical presentation. Its management requires input from several disciplines and is often coordinated by a gastroenterologist. This review examines demographics, clinical presentation, aetiology, diagnosis and prognosis; a suggested management approach, including antibiotic selection, radiological intervention and indications for surgery, is offered from a physician's perspective.

Keywords: Antibiotics; Computer Tomography; Infectious Disease; Liver.

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Figures

Figure 1
Figure 1
Abdominal ultrasound image of a pyogenic liver abscess. Note fluid-filled lesion with echogenic debris, septation and air bubbles.
Figure 2
Figure 2
Transverse image from abdominal CT scan: small pyogenic liver abscess adjacent to the gallbladder. This case was a complication of acute calculous cholecystitis. Antibiotic monotherapy was successful and cholecystectomy was planned for later.
Figure 3
Figure 3
Transverse image from abdominal CT scan: large, multiseptate right lobe pyogenic liver abscess.
Figure 4
Figure 4
Transverse image from abdominal CT scan: multiseptated left lobe pyogenic liver abscess. The causative agent in this case was Klebsiella, although there are no features on CT that distinguish Klebsiella from other bacterial pathogens.
Figure 5
Figure 5
Transverse image from abdominal CT scan: three small separate pyogenic liver abscesses resulting from a diverticular abscess.
Figure 6
Figure 6
Suggested approach to the management of pyogenic liver abscess. GI, gastrointestinal; PLA, pyogenic liver abscess.
Figure 7
Figure 7
Multiple choice question 3.
See this image and copyright information in PMC

References

    1. Meddings L, Myers RP, Hubbard J, et al. A population-based study of pyogenic liver abscesses in the United States: incidence, mortality and temporal trends. Am J Gastroenterol 2009;105:117–24. - PubMed
    1. Johannsen EC, Sifri CD, Madoff LC. Pyogenic liver abscesses. Infect Dis Clin North Am 2000;14:547–63. - PubMed
    1. Heneghan HM, Healy NA, Martin ST, et al. Modern management of pyogenic hepatic abscess: a case series and review of the literature. BMC Research Notes 2011;4:80. - PMC - PubMed
    1. Mezhir JJ, Fong Y, Jacks LM, et al. Current management of pyogenic liver abscess: surgery is now second-line treatment. J Am Coll Surg 2010;210:975–83. - PubMed
    1. Siu LK, Yeh K-M, Lin J-C, et al. Klebsiella pneumoniae liver abscess: a new invasive syndrome. Lancet Infect Dis 2012;12:881–7. - PubMed

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