Skip to main content
SpringerLink
Log in

Hepatic Abscesses

  • Chapter
  • First Online:
Textbook of Emergency General Surgery

  • 114 Accesses

Abstract

Background: Hepatic abscess can develop as a consequence of both intra- and extra-abdominal infection. Although pyogenic abscess is classically associated with appendicitis, it is now more common in cases of biliary pathology. Amebic abscess and hydatid disease can develop as a consequence of travel to endemic area and ingestion of contaminated food.

Methods: A systematic review of the literature was performed using the PubMed database using the keywords “hepatic abscess,” “pyogenic abscess,” “amebic abscess,” “hydatid cyst,” “fungal abscess.” Case series, randomized controlled trials, and review articles were included in our search.

Diagnosis/treatment: Diagnosis relies on history to determine the type of abscess and any travel to endemic area. Equally important are imaging studies to delineate the morphology of the abscess and any anatomic considerations prior to treatment. Treatment generally consists of appropriate antimicrobial therapy and cyst aspiration, although in the case of hydatid disease cyst excision is the standard approach. In this chapter, we seek to offer a better understanding of hepatic abscess and provide strategies for its optimal management.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Mavilia MG, Molina M, Wu GY. The evolving nature of hepatic abscess: a review. J Clin Transl Hepatol. 2016;4(2):158–68.

    PubMed  PubMed Central  Google Scholar 

  2. Kaplan GG, Gregson DB, Laupland KB. Population-based study of the epidemiology of and the risk factors for pyogenic liver abscess. Clin Gastroenterol Hepatol. 2004;2(11):1032–8.

    Article  PubMed  Google Scholar 

  3. Tsai FC, Huang YT, Chang LY, Wang JT. Pyogenic liver abscess as endemic disease. Taiwan Emerg Infect Dis. 2008;14(10):1592–600.

    Article  PubMed  Google Scholar 

  4. Lardière-Deguelte S, Ragot E, Amroun K, Piardi T, Dokmak S, Bruno O, et al. Hepatic abscess: diagnosis and management. J Visc Surg. 2015;152(4):231–43.

    Article  PubMed  Google Scholar 

  5. Qu K, Liu C, Wang ZX, Tian F, Wei JC, Tai MH, et al. Pyogenic liver abscesses associated with nonmetastatic colorectal cancers: an increasing problem in Eastern Asia. World J Gastroenterol. 2012;18(23):2948–55.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Roediger R, Lisker-Melman M. Pyogenic and amebic infections of the liver. Gastroenterol Clin N Am. 2020;49(2):361–77.

    Article  Google Scholar 

  7. Lin HF, Liao KF, Chang CM, Lin CL, Lai SW. Correlation between proton pump inhibitors and risk of pyogenic liver abscess. Eur J Clin Pharmacol. 2017;73(8):1019–25.

    Article  CAS  PubMed  Google Scholar 

  8. Reid-Lombardo KM, Khan S, Sclabas G. Hepatic cysts and liver abscess. Surg Clin N Am. 2010;90(4):679–97.

    Article  PubMed  Google Scholar 

  9. Barnes PF, De Cock KM, Reynolds TN, Ralls PW. A comparison of amebic and pyogenic abscess of the liver. Medicine (Baltimore). 1987;66(6):472–83.

    Article  CAS  PubMed  Google Scholar 

  10. Krige JEJ, Beckingham J. Liver abscesses and hydatid disease. Bmj. 2001;322:537–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Torre A, Kershenobich D. Amebic liver abscess. Ann Hepatol. 2002;1(1):45–7.

    Article  PubMed  Google Scholar 

  12. Mulholland MW, Lillemoe KD, Doherty GM, Upchurch GR Jr, Alam HB, Pawlik TM. Greenfield’s surgery. 6th ed. Baltimore: Wolters Kluwer; 2017. p. 930–41.

    Google Scholar 

  13. Marn H, Ignatius R, Tannich E, Harms G, Schürmann M, Dieckmann S. Amoebic liver abscess with negative serologic markers for Entamoeba histolytica: mind the gap! Infection. 2012;40(1):87–91.

    Article  CAS  PubMed  Google Scholar 

  14. Pakala T, Molina M, Wu GY. Hepatic echinococcal cysts: a review. J Clin Transl Hepatol. 2016;4(1):39–46. https://doi.org/10.14218/JCTH.2015.00036.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Lipsett PA, Huang CJ, Lillemoe KD, Cameron JL, Pitt HA. Fungal hepatic abscesses: characterization and management. J Gastrointest Surg. 1997;1(1):78–84.

    Article  CAS  PubMed  Google Scholar 

  16. Cameron JL, Cameron AM. Current surgical therapy. 13th ed. Amsterdam: Elsevier; 2020. p. 388–93.

    Google Scholar 

  17. Johannsen EC, Sifri CD, Madoff LC. Pyogenic liver abscesses. Infect Dis Clin N Am. 2000;14(3):547–63.

    Article  CAS  Google Scholar 

  18. Serraino C, Elia C, Bracco C, et al. Characteristics and management of pyogenic liver abscess: a European experience. Medicine (Baltimore). 2018;97(19):e0628.

    Article  PubMed  Google Scholar 

  19. Huang W-K, Chang JW-C, See L-C, Tu H-T, Chen J-S, Liaw C-C, et al. Higher rate of colorectal cancer among patients with pyogenic liver abscess with Klebsiella pneumoniae than those without: an 11-year follow-up study. Color Dis. 2012;14(12):e794–801.

    Article  Google Scholar 

  20. Leggieri N, Marques-Vidal P, Cerwenka H, Denys A, Dorta G, Moutardier V, et al. Migrated foreign body liver abscess illustrative case report, systematic review, and proposed diagnostic algorithm. Medicine (Baltimore). 2010;89(2):85–95.

    Article  PubMed  Google Scholar 

  21. Nachman S, Kaul A, Li KI, Slim MS, Filippo JAS, Van Horn K. Liver abscess caused by Clostridium bifermentans following blunt abdominal trauma. J Clin Microbiol. 1989;27(5):1137–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Bhutani N, Kajal P. Hepatic echinococcosis: a review. Ann Med Surg (Lond). 2018;36:99–105. https://doi.org/10.1016/j.amsu.2018.10.032.

    Article  PubMed  Google Scholar 

  23. Webb GJ, Chapman TP, Cadman PJ, Gorard DA. Pyogenic liver abscess. Frontline Gastroenterol. 2014;5(1):60–7.

    Article  PubMed  Google Scholar 

  24. Shi SH, Zhai ZL, Zheng SS. Pyogenic liver abscess of biliary origin: the existing problems and their strategies. Semin Liver Dis. 2018;38(3):270–83. https://doi.org/10.1055/s-0038-1661363.

    Article  PubMed  Google Scholar 

  25. Stanley SL Jr. Amoebiasis. Lancet. 2003;361:1025–35.

    Article  CAS  PubMed  Google Scholar 

  26. Bächler P, Baladron MJ, Menias C, Beddings I, Loch R, Zalaquett E, et al. Multimodality imaging of liver infections: differential diagnosis and potential pitfalls. Radiographics. 2016;36(4):1001–23.

    Article  PubMed  Google Scholar 

  27. Conter RL, Pitt HA, Tompkins RK, Longmire WP Jr. Differentiation of pyogenic from amebic hepatic abscesses. Surg Gynecol Obstet. 1986;162(2):114–20.

    CAS  PubMed  Google Scholar 

  28. Ngui R, Angal L, Fakhrurrazi SA, Lian YLA, Ling LY, Ibrahim J, et al. Differentiating Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii using nested polymerase chain reaction (PCR) in rural communities in Malaysia. Parasites Vectors. 2012;5(1):1.

    Article  Google Scholar 

  29. Skappak C, Akierman S, Belga S, Novak K, Chadee K, Urbanski SJ, et al. Invasive amoebiasis: a review of Entamoeba infections highlighted with case reports. Can J Gastroenterol Hepatol. 2014;28(7):355–9.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Macpherson CN, Bartholomot B, Frider B. Application of ultrasound in diagnosis, treatment, epidemiology, public health and control of Echinococcus granulosus and E. multilocularis. Parasitology. 2003;127(Suppl):S21–35. https://doi.org/10.1017/s0031182003003676.

    Article  PubMed  Google Scholar 

  31. Theel ES, Doern CD. β-d-Glucan testing is important for diagnosis of invasive fungal infections. J Clin Microbiol. 2013;51(11):3478–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Cai YL, Xiong XZ, Lu J, et al. Percutaneous needle aspiration versus catheter drainage in the management of liver abscess: a systematic review and meta-analysis. HPB (Oxford). 2015;17(3):195–201. https://doi.org/10.1111/hpb.12332.

    Article  PubMed  Google Scholar 

  33. Van Allan RJ, Katz MD, Johnson MB, Laine LA, Liu Y, Ralls PW. Uncomplicated amoebic liver abscess: prospective evaluation of percutaneous aspiration. Radiology. 1992;183:827–30.

    Article  PubMed  Google Scholar 

  34. Weinke T, Grobusch MP, Güthoff W. Amebic liver abscess—rare need for percutaneous treatment modalities. Eur J Med Res. 2002;7(1):25–9.

    PubMed  Google Scholar 

  35. Heneghan HM, Healy NA, Martin ST, et al. Modern management of pyogenic hepatic abscess: a case series and review of the literature. BMC Res Notes. 2011;4:80.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Zeng R, Wu R, Lv Q, Tong N, Zhang Y. The association of hypernatremia and hypertonic saline irrigation in hepatic hydatid cysts. Medicine (Baltimore). 2017;96(37):e7889.

    Article  PubMed  Google Scholar 

Further Reading

  • Bächler P, Baladron MJ, Menias C, Beddings I, Loch R, Zalaquett E, et al. Multimodality imaging of liver infections: differential diagnosis and potential pitfalls. Radiographics. 2016;36(4):1001–23.

    Article  PubMed  Google Scholar 

  • Barnes PF, De Cock KM, Reynolds TN, Ralls PW. A comparison of amebic and pyogenic abscess of the liver. Medicine (Baltimore). 1987;66(6):472–83.

    Article  CAS  PubMed  Google Scholar 

  • Lipsett PA, Huang CJ, Lillemoe KD, Cameron JL, Pitt HA. Fungal hepatic abscesses: characterization and management. J Gastrointest Surg. 1997;1(1):78–84.

    Article  CAS  PubMed  Google Scholar 

  • Mavilia MG, Molina M, Wu GY. The evolving nature of hepatic abscess: a review. J Clin Transl Hepatol. 2016;4(2):158–68.

    PubMed  PubMed Central  Google Scholar 

  • Reid-Lombardo KM, Khan S, Sclabas G. Hepatic cysts and liver abscess. Surg Clin N Am. 2010;90(4):679–97.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA

    Kyra N. Folkert, Sarah Khalil & Robert Sawyer

Authors
  1. Kyra N. Folkert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sarah Khalil
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert Sawyer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert Sawyer .

Editor information

Editors and Affiliations

  1. General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Pisa, Italy

    Federico Coccolini

  2. General and Emergency Surgery Dept., Bufalini Hospital, Cesena, Italy

    Fausto Catena

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Folkert, K.N., Khalil, S., Sawyer, R. (2023). Hepatic Abscesses. In: Coccolini, F., Catena, F. (eds) Textbook of Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-22599-4_61

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-22599-4_61

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-22598-7

  • Online ISBN: 978-3-031-22599-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation