Liver abscesses may be:
- Pyogenic (80% of liver abscesses in the developed world)
- Amoebic
- Fungal
Presentation:
- Fever
- Abdominal pain/tenderness
- Nausea/vomiting
- Chest pain
- Weight loss
- Rarely: cough/hiccups from diaphragmatic irritation
Diagnosis:
- US
- CT
- Bloods – raised ALP commonest finding on LFTs
Management
- 2-3 weeks broad-spectrum IV antibiotics followed by 2-4 weeks oral antibiotics
- Percutaneous drainage if >3cm in size
- Surgical drainage if multiple/loculated abscess
Small print gem: most abscesses (around 70%) are in the right lobe of the liver
References