Liver Abscess

Overview
  • The liver is a common site of abscess formation which can occur due to a wide variety of infectious agents. The organisms which result in liver abscesses are generally different in developed and developing countries.
Etiology and Pathogenesis
  • Developed Countries
    • The etiological agents of hepatic abscesses in developed countries is usually bacteria which can seed the liver by a number of routes. Bacteria from the alimentary tract due infections such as acute appendicitis can gain access to the liver via the portal vein. Bacteria from cases of ascending cholangitis gain hepatic access via the bile ducts. In some cases, bacteria can gain access to the liver via direct extension from a source in the peritoneum.
  • Developing Countries
    • In developing countries hepatic abscesses are usually due to parasitic or helminthic infections. The route of these organisms to the liver is unique to each organism.
Clinical Consequences
  • Hepatic Abscesses present with traditional nonspecific symptoms of infection which include constitutional symptoms such as fever, weight loss, anorexia, and vomiting. Symptoms specific to the liver include jaundice, hepatomegaly, and abdominal pain localizing to the right upper quadrant. Leukocytosis characteristic of an infectious process and elevated serum alkaline phosphatase characteristic of liver damage is also common.