Pyogenic liver abscess natural history, complications and prognosis: Difference between revisions
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==Overview== | ==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.<ref name="pmid2256756">{{cite journal| author=Branum GD, Tyson GS, Branum MA, Meyers WC| title=Hepatic abscess. Changes in etiology, diagnosis, and management. | journal=Ann Surg | year= 1990 | volume= 212 | issue= 6 | pages= 655-62 | pmid=2256756 | doi= | pmc=1358249 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2256756 }} </ref><ref name="pmid3052693">{{cite journal| author=Farges O, Leese T, Bismuth H| title=Pyogenic liver abscess: an improvement in prognosis. | journal=Br J Surg | year= 1988 | volume= 75 | issue= 9 | pages= 862-5 | pmid=3052693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3052693 }} </ref><ref name="pmid1124472">{{cite journal| author=Pitt HA, Zuidema GD| title=Factors influencing mortality in the treatment of pyogenic hepatic abscess. | journal=Surg Gynecol Obstet | year= 1975 | volume= 140 | issue= 2 | pages= 228-34 | pmid=1124472 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1124472 }} </ref>Complications of pyogenic liver abscess include septicemia, | If left untreated, pyogenic liver abscess may progress to [[peritonitis]] or [[pleuritis]] secondary to rupture of the [[abscess]] into [[peritoneal cavity|peritoneal]] or [[pleural cavity|pleural cavities]] and [[sepsis]].<ref name="pmid2256756">{{cite journal| author=Branum GD, Tyson GS, Branum MA, Meyers WC| title=Hepatic abscess. Changes in etiology, diagnosis, and management. | journal=Ann Surg | year= 1990 | volume= 212 | issue= 6 | pages= 655-62 | pmid=2256756 | doi= | pmc=1358249 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2256756 }} </ref><ref name="pmid3052693">{{cite journal| author=Farges O, Leese T, Bismuth H| title=Pyogenic liver abscess: an improvement in prognosis. | journal=Br J Surg | year= 1988 | volume= 75 | issue= 9 | pages= 862-5 | pmid=3052693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3052693 }} </ref><ref name="pmid1124472">{{cite journal| author=Pitt HA, Zuidema GD| title=Factors influencing mortality in the treatment of pyogenic hepatic abscess. | journal=Surg Gynecol Obstet | year= 1975 | volume= 140 | issue= 2 | pages= 228-34 | pmid=1124472 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1124472 }} </ref>Complications of pyogenic liver abscess include [[septicemia]], [[Abscess|intra-abdominal abscess]], [[hepatic failure]], [[renal failure]], recurrent [[liver abscess]] and free [[peritonitis]].<ref name="pmid21206721">{{cite journal| author=Malik AA, Bari SU, Rouf KA, Wani KA| title=Pyogenic liver abscess: Changing patterns in approach. | journal=World J Gastrointest Surg | year= 2010 | volume= 2 | issue= 12 | pages= 395-401 | pmid=21206721 | doi=10.4240/wjgs.v2.i12.395 | pmc=3014521 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21206721 }} </ref>The prognosis of liver abscess depends on underlying risk factors such as advanced age, [[malignancy]], [[jaundice]], multiple [[abscess|abscesses]], [[Anemia|hemoglobin <10g/dl]] and elevated [[blood urea nitrogen]].<ref name="pmid8651751">{{cite journal| author=Huang CJ, Pitt HA, Lipsett PA, Osterman FA, Lillemoe KD, Cameron JL et al.| title=Pyogenic hepatic abscess. Changing trends over 42 years. | journal=Ann Surg | year= 1996 | volume= 223 | issue= 5 | pages= 600-7; discussion 607-9 | pmid=8651751 | doi= | pmc=1235191 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8651751 }} </ref> | ||
==Natural History== | ==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.<ref name="pmid2256756">{{cite journal| author=Branum GD, Tyson GS, Branum MA, Meyers WC| title=Hepatic abscess. Changes in etiology, diagnosis, and management. | journal=Ann Surg | year= 1990 | volume= 212 | issue= 6 | pages= 655-62 | pmid=2256756 | doi= | pmc=1358249 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2256756 }} </ref><ref name="pmid3052693">{{cite journal| author=Farges O, Leese T, Bismuth H| title=Pyogenic liver abscess: an improvement in prognosis. | journal=Br J Surg | year= 1988 | volume= 75 | issue= 9 | pages= 862-5 | pmid=3052693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3052693 }} </ref><ref name="pmid1124472">{{cite journal| author=Pitt HA, Zuidema GD| title=Factors influencing mortality in the treatment of pyogenic hepatic abscess. | journal=Surg Gynecol Obstet | year= 1975 | volume= 140 | issue= 2 | pages= 228-34 | pmid=1124472 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1124472 }} </ref> | If left untreated, pyogenic liver abscess may progress to [[peritonitis]] or [[pleuritis]] secondary to rupture of the [[abscess]] into [[peritoneal cavity|peritoneal]] or [[pleural cavity|pleural cavities]] and [[sepsis]] leading to death.<ref name="pmid2256756">{{cite journal| author=Branum GD, Tyson GS, Branum MA, Meyers WC| title=Hepatic abscess. Changes in etiology, diagnosis, and management. | journal=Ann Surg | year= 1990 | volume= 212 | issue= 6 | pages= 655-62 | pmid=2256756 | doi= | pmc=1358249 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2256756 }} </ref><ref name="pmid3052693">{{cite journal| author=Farges O, Leese T, Bismuth H| title=Pyogenic liver abscess: an improvement in prognosis. | journal=Br J Surg | year= 1988 | volume= 75 | issue= 9 | pages= 862-5 | pmid=3052693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3052693 }} </ref><ref name="pmid1124472">{{cite journal| author=Pitt HA, Zuidema GD| title=Factors influencing mortality in the treatment of pyogenic hepatic abscess. | journal=Surg Gynecol Obstet | year= 1975 | volume= 140 | issue= 2 | pages= 228-34 | pmid=1124472 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1124472 }} </ref> | ||
==Complications== | ==Complications== | ||
Complications of pyogenic liver abscess include:<ref name="pmid21206721">{{cite journal| author=Malik AA, Bari SU, Rouf KA, Wani KA| title=Pyogenic liver abscess: Changing patterns in approach. | journal=World J Gastrointest Surg | year= 2010 | volume= 2 | issue= 12 | pages= 395-401 | pmid=21206721 | doi=10.4240/wjgs.v2.i12.395 | pmc=3014521 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21206721 }} </ref> | Complications of pyogenic liver abscess include:<ref name="pmid21206721">{{cite journal| author=Malik AA, Bari SU, Rouf KA, Wani KA| title=Pyogenic liver abscess: Changing patterns in approach. | journal=World J Gastrointest Surg | year= 2010 | volume= 2 | issue= 12 | pages= 395-401 | pmid=21206721 | doi=10.4240/wjgs.v2.i12.395 | pmc=3014521 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21206721 }} </ref> | ||
*Septicemia | *[[Septicemia]] | ||
*Intra abdominal abscess | *[[abdominal|Intra abdominal]] [[abscess]] | ||
*Hepatic failure | *[[Hepatic failure]] | ||
*Renal failure | *[[Renal failure]] | ||
*Recurrent liver abscess | *Recurrent [[liver abscess]] | ||
*Massive upper gastrointestinal bleed | *Massive [[upper gastrointestinal bleed]] | ||
*Prolonged biliary drainage | *Prolonged [[bile duct|biliary]] drainage | ||
*Free peritonitis | *Free [[peritonitis]] | ||
==Prognosis== | ==Prognosis== | ||
*The prognosis has improved markedly with early diagnosis, drainage and long term antibiotic therapy.<ref name="pmid8611070">{{cite journal| author=Chu KM, Fan ST, Lai EC, Lo CM, Wong J| title=Pyogenic liver abscess. An audit of experience over the past decade. | journal=Arch Surg | year= 1996 | volume= 131 | issue= 2 | pages= 148-52 | pmid=8611070 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8611070 }} </ref> | *The prognosis has improved markedly with early diagnosis, drainage and long term [[antibiotic therapy]].<ref name="pmid8611070">{{cite journal| author=Chu KM, Fan ST, Lai EC, Lo CM, Wong J| title=Pyogenic liver abscess. An audit of experience over the past decade. | journal=Arch Surg | year= 1996 | volume= 131 | issue= 2 | pages= 148-52 | pmid=8611070 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8611070 }} </ref> | ||
*If left untreated [[abscess]] ruptures leading to death. | |||
*The prognosis of pyogenic liver abscess depends on underlying risk factors such as<ref name="pmid8651751">{{cite journal| author=Huang CJ, Pitt HA, Lipsett PA, Osterman FA, Lillemoe KD, Cameron JL et al.| title=Pyogenic hepatic abscess. Changing trends over 42 years. | journal=Ann Surg | year= 1996 | volume= 223 | issue= 5 | pages= 600-7; discussion 607-9 | pmid=8651751 | doi= | pmc=1235191 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8651751 }} </ref><ref name="pmid8606631">{{cite journal| author=Seeto RK, Rockey DC| title=Pyogenic liver abscess. Changes in etiology, management, and outcome. | journal=Medicine (Baltimore) | year= 1996 | volume= 75 | issue= 2 | pages= 99-113 | pmid=8606631 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8606631 }} </ref><ref name="pmid2256756">{{cite journal| author=Branum GD, Tyson GS, Branum MA, Meyers WC| title=Hepatic abscess. Changes in etiology, diagnosis, and management. | journal=Ann Surg | year= 1990 | volume= 212 | issue= 6 | pages= 655-62 | pmid=2256756 | doi= | pmc=1358249 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2256756 }} </ref> | *The prognosis of pyogenic liver abscess depends on underlying risk factors such as<ref name="pmid8651751">{{cite journal| author=Huang CJ, Pitt HA, Lipsett PA, Osterman FA, Lillemoe KD, Cameron JL et al.| title=Pyogenic hepatic abscess. Changing trends over 42 years. | journal=Ann Surg | year= 1996 | volume= 223 | issue= 5 | pages= 600-7; discussion 607-9 | pmid=8651751 | doi= | pmc=1235191 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8651751 }} </ref><ref name="pmid8606631">{{cite journal| author=Seeto RK, Rockey DC| title=Pyogenic liver abscess. Changes in etiology, management, and outcome. | journal=Medicine (Baltimore) | year= 1996 | volume= 75 | issue= 2 | pages= 99-113 | pmid=8606631 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8606631 }} </ref><ref name="pmid2256756">{{cite journal| author=Branum GD, Tyson GS, Branum MA, Meyers WC| title=Hepatic abscess. Changes in etiology, diagnosis, and management. | journal=Ann Surg | year= 1990 | volume= 212 | issue= 6 | pages= 655-62 | pmid=2256756 | doi= | pmc=1358249 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2256756 }} </ref> | ||
:*Advanced age | :*Advanced age | ||
:*Malignancy | :*[[Malignancy]] | ||
:*Shock | :*[[Shock]] | ||
:*Jaundice | :*[[Jaundice]] | ||
:*Multiple abscesses | :*Multiple [[abscess|abscesses]] | ||
:*Hemoglobin <10 g/dL | :*[[Hemoglobin]] <10 g/dL | ||
:*Elevated blood urea nitrogen | :*Elevated [[blood urea nitrogen]] | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} |
Latest revision as of 15:20, 31 March 2017
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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.