True about pyogenic liver abscess -
About 50% of hepatic abscesses are solitary. Their size may vary from less than a millimetre to several centimetres in diameter. It can be multiloculated or a single cavity. It usually involves the right lobe (~75%) Clinical features the classical description of the hepatic abscess is - fever, jaundice and . upper quadrant pain; but this is rarely seen (~10% cases) the most common presentation includes - fever with chills and abdominal pain (Fever is MC symptom) Nonspecific symptoms like malaise and anorexia are also seen Laboratory investigations Abnormalities of LFTs are generally seen but are not severe. Alkaline phosphatase & transaminases are mildly elevated Bilirubin is elevated in 20-50% patients. (Severe abnormalities of LFT are not seen in pyogenic liver abscess and if present, indicate underlying biliary pathology.) X-ray features are not diagnostic. They at the most can be suggestive of some subdiaphragmatic pathology (because of elevated . hemidiaphragm, . pleural effusions or atelectasis). Ultrasound and CT are the main diagnostic modalities. Diagnosis is confirmed by aspiration and culture. (Serology tests are helpful for diagnosing amoebic abscess, not a pyogenic liver abscess.) Treatment involves antibiotics and percutaneous catheter drainage. (Ref: Sabiston 18/e) Ref : Bailey & Love 25/e p1094
Single & large abscess
Systemic complaints, fever & jaundice common
X-ray features are diagnostic
Liver enzyme abnormalities are common & severe
G.I.T