Pyogenic liver abscess natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
If left untreated, pyogenic liver abscess may progress to peritonitis or pleuritis secondary to rupture of the abscess into peritoneal or pleural cavities and sepsis.[1][2][3]Complications of pyogenic liver abscess include septicemia, intra-abdominal abscess, hepatic failure, renal failure, recurrent liver abscess and free peritonitis.[4]The prognosis of liver abscess depends on underlying risk factors such as advanced age, malignancy, jaundice, multiple abscesses, hemoglobin <10g/dl and elevated blood urea nitrogen.[5]
Natural History
If left untreated, pyogenic liver abscess may progress to peritonitis or pleuritis secondary to rupture of the abscess into peritoneal or pleural cavities and sepsis leading to death.[1][2][3]
Complications
Complications of pyogenic liver abscess include:[4]
- Septicemia
- Intra abdominal abscess
- Hepatic failure
- Renal failure
- Recurrent liver abscess
- Massive upper gastrointestinal bleed
- Prolonged biliary drainage
- Free peritonitis
Prognosis
- The prognosis has improved markedly with early diagnosis, drainage and long term antibiotic therapy.[6]
- If left untreated abscess ruptures leading to death.
- The prognosis of pyogenic liver abscess depends on underlying risk factors such as[5][7][1]
- Advanced age
- Malignancy
- Shock
- Jaundice
- Multiple abscesses
- Hemoglobin <10 g/dL
- Elevated blood urea nitrogen
References
- ↑ 1.0 1.1 1.2 Branum GD, Tyson GS, Branum MA, Meyers WC (1990). "Hepatic abscess. Changes in etiology, diagnosis, and management". Ann Surg. 212 (6): 655–62. PMC 1358249. PMID 2256756.
- ↑ 2.0 2.1 Farges O, Leese T, Bismuth H (1988). "Pyogenic liver abscess: an improvement in prognosis". Br J Surg. 75 (9): 862–5. PMID 3052693.
- ↑ 3.0 3.1 Pitt HA, Zuidema GD (1975). "Factors influencing mortality in the treatment of pyogenic hepatic abscess". Surg Gynecol Obstet. 140 (2): 228–34. PMID 1124472.
- ↑ 4.0 4.1 Malik AA, Bari SU, Rouf KA, Wani KA (2010). "Pyogenic liver abscess: Changing patterns in approach". World J Gastrointest Surg. 2 (12): 395–401. doi:10.4240/wjgs.v2.i12.395. PMC 3014521. PMID 21206721.
- ↑ 5.0 5.1 Huang CJ, Pitt HA, Lipsett PA, Osterman FA, Lillemoe KD, Cameron JL; et al. (1996). "Pyogenic hepatic abscess. Changing trends over 42 years". Ann Surg. 223 (5): 600–7, discussion 607-9. PMC 1235191. PMID 8651751.
- ↑ Chu KM, Fan ST, Lai EC, Lo CM, Wong J (1996). "Pyogenic liver abscess. An audit of experience over the past decade". Arch Surg. 131 (2): 148–52. PMID 8611070.
- ↑ Seeto RK, Rockey DC (1996). "Pyogenic liver abscess. Changes in etiology, management, and outcome". Medicine (Baltimore). 75 (2): 99–113. PMID 8606631.