Liver mass medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Liver mass}} | {{Liver mass}} | ||
{{CMG}} ; {{AE}} {{ADG}} | {{CMG}}; {{AE}} {{ADG}} | ||
==Overview== | ==Overview== | ||
The majority of cases of liver masses (benign liver tumors) are asymptomatic and require only supportive care. Medical therapy is indicated only in cases of cystic lesions. Surgery is the main stay of treatment for solid lesions. | |||
==Medical therapy== | ==Medical therapy== | ||
The majority of cases of liver masses (benign liver tumors) are asymptomatic and require only supportive care. Medical therapy is indicated only in cases of cystic lesions. Surgery is the mainstay of treatment for solid lesions. | |||
===Management of cystic liver lesions=== | ===Management of cystic liver lesions=== | ||
Hepatic abscess | * '''Hepatic abscess''' | ||
*Empiric [[antibiotic]] therapy based on [[Culture medium|culture]] and sensitivity include:<ref name="pmid12380791">{{cite journal| author=Chen YW, Chen YS, Lee SS, Yen MY, Wann SR, Lin HH et al.| title=A pilot study of oral fleroxacin once daily compared with conventional therapy in patients with pyogenic liver abscess. | journal=J Microbiol Immunol Infect | year= 2002 | volume= 35 | issue= 3 | pages= 179-83 | pmid=12380791 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12380791 }} </ref><ref name="pmid15057896">{{cite journal| author=Yu SC, Ho SS, Lau WY, Yeung DT, Yuen EH, Lee PS et al.| title=Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration. | journal=Hepatology | year= 2004 | volume= 39 | issue= 4 | pages= 932-8 | pmid=15057896 | doi=10.1002/hep.20133 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15057896 }} </ref> | **Empiric [[antibiotic]] therapy based on [[Culture medium|culture]] and sensitivity include:<ref name="pmid12380791">{{cite journal| author=Chen YW, Chen YS, Lee SS, Yen MY, Wann SR, Lin HH et al.| title=A pilot study of oral fleroxacin once daily compared with conventional therapy in patients with pyogenic liver abscess. | journal=J Microbiol Immunol Infect | year= 2002 | volume= 35 | issue= 3 | pages= 179-83 | pmid=12380791 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12380791 }} </ref><ref name="pmid15057896">{{cite journal| author=Yu SC, Ho SS, Lau WY, Yeung DT, Yuen EH, Lee PS et al.| title=Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration. | journal=Hepatology | year= 2004 | volume= 39 | issue= 4 | pages= 932-8 | pmid=15057896 | doi=10.1002/hep.20133 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15057896 }} </ref> | ||
***1.[[Monotherapy]] | |||
****Preferred regimen(1):[[Ampicillin]]-[[sulbactam]] 3 g IV every six hours | |||
****Preferred regimen(2):[[Piperacillin]]-[[tazobactam]] 3.375 or 4.5 g IV every six hours | |||
****Preferred regimen(3):[[Ticarcillin]]-[[clavulanate]] 3.1 g IV every four hours | |||
***2.[[Combination therapy]] | |||
****Preferred regimen(1):[[Ceftriaxone]] 1 g IV every 24 hours or 2 g IV every 12 hours for [[CNS]] [[infection]] '''plus''' [[Metronidazole]] 500 mg IV every eight hours | |||
''' | * '''Hepatic echinococcosis''' | ||
** Management depends upon the cystic grading | |||
*** There are 3 options for the treatment of [[cystic]] [[echinococcosis]]: anti-infective [[drug]] treatment, [[percutaneous]] treatment of the [[Hydatid cyst|hydatid cysts]] with the PAIR (Puncture, Aspiration, [[Injection (medicine)|Injection]], Re-aspiration) technique and surgery. | |||
**** Preferred regimen: [[Albendazole]] 10 to 15 mg/kg per day q12 | |||
**** Alternative regimen: Puncture, [[aspiration]], [[injection]], re-aspiration (PAIR) | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Medicine]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Hepatology]] | |||
[[Category:Oncology]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Surgery]] | |||
: | |||
Latest revision as of 22:32, 29 July 2020
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Risk calculators and risk factors for Liver mass medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
The majority of cases of liver masses (benign liver tumors) are asymptomatic and require only supportive care. Medical therapy is indicated only in cases of cystic lesions. Surgery is the main stay of treatment for solid lesions.
Medical therapy
The majority of cases of liver masses (benign liver tumors) are asymptomatic and require only supportive care. Medical therapy is indicated only in cases of cystic lesions. Surgery is the mainstay of treatment for solid lesions.
Management of cystic liver lesions
- Hepatic abscess
- Empiric antibiotic therapy based on culture and sensitivity include:[1][2]
- 1.Monotherapy
- Preferred regimen(1):Ampicillin-sulbactam 3 g IV every six hours
- Preferred regimen(2):Piperacillin-tazobactam 3.375 or 4.5 g IV every six hours
- Preferred regimen(3):Ticarcillin-clavulanate 3.1 g IV every four hours
- 2.Combination therapy
- Preferred regimen(1):Ceftriaxone 1 g IV every 24 hours or 2 g IV every 12 hours for CNS infection plus Metronidazole 500 mg IV every eight hours
- 1.Monotherapy
- Empiric antibiotic therapy based on culture and sensitivity include:[1][2]
- Hepatic echinococcosis
- Management depends upon the cystic grading
- There are 3 options for the treatment of cystic echinococcosis: anti-infective drug treatment, percutaneous treatment of the hydatid cysts with the PAIR (Puncture, Aspiration, Injection, Re-aspiration) technique and surgery.
- Preferred regimen: Albendazole 10 to 15 mg/kg per day q12
- Alternative regimen: Puncture, aspiration, injection, re-aspiration (PAIR)
- There are 3 options for the treatment of cystic echinococcosis: anti-infective drug treatment, percutaneous treatment of the hydatid cysts with the PAIR (Puncture, Aspiration, Injection, Re-aspiration) technique and surgery.
- Management depends upon the cystic grading
References
- ↑ Chen YW, Chen YS, Lee SS, Yen MY, Wann SR, Lin HH; et al. (2002). "A pilot study of oral fleroxacin once daily compared with conventional therapy in patients with pyogenic liver abscess". J Microbiol Immunol Infect. 35 (3): 179–83. PMID 12380791.
- ↑ Yu SC, Ho SS, Lau WY, Yeung DT, Yuen EH, Lee PS; et al. (2004). "Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration". Hepatology. 39 (4): 932–8. doi:10.1002/hep.20133. PMID 15057896.