Liver Pathology 2
BACTERIAL HEPATIC ABSCESSES
Etiology
Ascending Biliary Contamination–cholangitis
-frequent
-due to:-biliary lithiasis
-Caroli disease
-hydatid cyst
Hematogenic Contamination (portal or arterial):
-intraabdominal infections (appendicitis, diverticulitis)
-other infections (endocarditis)
Hepatic lesions infection: trauma, tumoral necrosis, parasites, foreign bodies, etc.
Germs
-Gram negative germs: E.coli
-Anaerobs: Bacteroides, Streptococcus
-Gram positive germs: extra-abdominal sources
Clinical Signs
-Fever, shiver
-Right upper quadrant pain
-±Jaundice, Hemobilia
-Severe sepsis
Lab Tests
1
, -Leucocitosis
-Anemia
-Altered liver function, especially Alkaline Phosphatase
-US, CT, MRI
-Abdominal X-Ray: liquid –gas image
Treatment:
-Surgery, AB
-Percutaneous Drainage guided CT, US
-Multiple Abcesses:AB
-NUTRITION!!(very catabolic pacients)
MORTALITY:40% in difficult cases
E. Hystolityca
-About 10 percent of the world's population is infected with E.Histolytica.
-the third most common cause of death (after Schistosomiasis and Malaria) from
parasitic infections.
-very high incidence in tropical countries like India, Mexico, Central and South America.
-About 90 percent of infections are asymptomatic
-the remaining 1O percent produces a spectrum varying from dysentery to amoebic liver
abscess
-commonly spread by water contaminated by faeces or from food served by
contaminated hand
Amoebiasic Abscess
2
BACTERIAL HEPATIC ABSCESSES
Etiology
Ascending Biliary Contamination–cholangitis
-frequent
-due to:-biliary lithiasis
-Caroli disease
-hydatid cyst
Hematogenic Contamination (portal or arterial):
-intraabdominal infections (appendicitis, diverticulitis)
-other infections (endocarditis)
Hepatic lesions infection: trauma, tumoral necrosis, parasites, foreign bodies, etc.
Germs
-Gram negative germs: E.coli
-Anaerobs: Bacteroides, Streptococcus
-Gram positive germs: extra-abdominal sources
Clinical Signs
-Fever, shiver
-Right upper quadrant pain
-±Jaundice, Hemobilia
-Severe sepsis
Lab Tests
1
, -Leucocitosis
-Anemia
-Altered liver function, especially Alkaline Phosphatase
-US, CT, MRI
-Abdominal X-Ray: liquid –gas image
Treatment:
-Surgery, AB
-Percutaneous Drainage guided CT, US
-Multiple Abcesses:AB
-NUTRITION!!(very catabolic pacients)
MORTALITY:40% in difficult cases
E. Hystolityca
-About 10 percent of the world's population is infected with E.Histolytica.
-the third most common cause of death (after Schistosomiasis and Malaria) from
parasitic infections.
-very high incidence in tropical countries like India, Mexico, Central and South America.
-About 90 percent of infections are asymptomatic
-the remaining 1O percent produces a spectrum varying from dysentery to amoebic liver
abscess
-commonly spread by water contaminated by faeces or from food served by
contaminated hand
Amoebiasic Abscess
2
