Pyogenic liver abscess pathophysiology: Difference between revisions
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==Gross Pathology== | ==Gross Pathology== | ||
*Single or multiple cavities, filled with fowl smelling, creamy yellow necrotic material, usually in right lobe. | |||
*The abscess may have fibrous capsule. | |||
==Microscopic Pathology== | |||
*Multiple neutrophilic abscess with areas of necrosis are seen in the liver parencyma.<ref name=abscess>https://librepathology.org/wiki/Liver_pathology Accessed on February 22, 2017</ref> | |||
*Adjacent hepatocytes appear reactive. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 16:08, 22 February 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
Pathophysiology
- Development of pyogenic liver abscess is the result of extension of infection through the following:[1][2][3][4]
- Portal vein
- Hepatic arteries as metastatic abscessess
- Direct spread from nearby infection
- Trauma
- Retroperitoneal extension from appendix (suppurative appendicitis most frequent source of infection)
- Ascending biliary infection is the most common source of pyogenic liver abscess
- Bacteria involved in pyogenic liver abscess include:
Pathogenesis
In healthy patients the reticuloendothelial cells (kuffer cells) of liver control the transient portal bacteremia but in elderly and immunocompromised the bacteria can overwhelm the kuffer cells and lead to an abscess.[5]
Gross Pathology
- Single or multiple cavities, filled with fowl smelling, creamy yellow necrotic material, usually in right lobe.
- The abscess may have fibrous capsule.
Microscopic Pathology
- Multiple neutrophilic abscess with areas of necrosis are seen in the liver parencyma.[6]
- Adjacent hepatocytes appear reactive.
References
- ↑ Munro JC (1905). "VII. Lymphatic and Hepatic Infections Secondary to Appendicitis". Ann Surg. 42 (5): 692–734. PMC 1425980. PMID 17861705.
- ↑ 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.
- ↑ Rahimian J, Wilson T, Oram V, Holzman RS (2004). "Pyogenic liver abscess: recent trends in etiology and mortality". Clin Infect Dis. 39 (11): 1654–9. doi:10.1086/425616. PMID 15578367.
- ↑ Lam YH, Wong SK, Lee DW, Lau JY, Chan AC, Yiu RY; et al. (1999). "ERCP and pyogenic liver abscess". Gastrointest Endosc. 50 (3): 340–4. doi:10.1053/ge.1999.v50.98065. PMID 10462653.
- ↑ Stain SC, Yellin AE, Donovan AJ, Brien HW (1991). "Pyogenic liver abscess. Modern treatment". Arch Surg. 126 (8): 991–6. PMID 1863218.
- ↑ https://librepathology.org/wiki/Liver_pathology Accessed on February 22, 2017