Sandbox:YK

Amoebic liver abscess diagnosis

Diagnosis of amoebic liver abscess

Signs and symptoms(a) Fever, abdominal pain, point tenderness over the liver, hepatomegaly, weight loss History Travel to endemic areas, immigrant from endemic areas, having had dysentery within last years, gender (male/female:9/1

Laboratory diagnosis(LD) and Radiologic Methods (RM) (US, CT or MRI)

LD negative and RM negative:Floow

LD negative and RM positive:aspiration, if possible(b)

LD positive and RM positive: chemotherapy / surgical treatment

Pyogenic abscesses Neoplasia (hepatocellular carcinoma) Cysticercosis Cystic echinococcosis

ALA

Liver abscess

Liver abscess

Risk factors

Hematogenous

Biliary

Underlying lesions or anamolies

Other causes

Portal vein Intra-abdominal infection Pyelophlebitis Abdominal abscess Amoebiasis Arterial ENT Oral cavity

Gall stones Obstructed bile duct Contiguous spread, ascending cholangitis Bile duct ischemia

Biliary cyst Hydatid cyst Cystadenoma Necrosis of a primary tumor Superinfection of a metastasis Caroli disease Biliary stricture Sclerosing cholangitis Ischemic cholangitis

Radiofrequency ablation / Chemoembolization in the presence of infected bile Pancreatoduodenectomy Liver transplantation Hepatic trauma ± arterial embolization

Causes liver abscess

Pyogenic liver abscess

Causes

Hepatobiliary

Portal

Arterial

Traumatic

Cryptogenic

Benign

Malignant

Benign

Malignant

• Endocarditis • Vascular sepsis • Dental infection • ENT infection

Benign

Malignant

• Lithiasis • Cholicystitis • Biliary enteric anastomosis • Percutaneous biliary procedures • Endoscopic biliary procedures

• Gall bladder • Common bile duct • Head of pancreas • Ampulla

• Appendicitis • Diverticulitis • Pelvic suppuration • Anorectal suppuration • Pancreatic abscess • Postoperative sepsis • Intestinal perforation • Inflammatory bowel disease

• Gastric cancer • Colon cancer

• Open or closed abdominal trauma

• Percutaneous ethanol injection or radiofrequency • Chemoembolization