Liver Abscess
A pus-filled mass inside the liver caused by bacterial, parasitic, or amoebic infection.
Overview
Liver abscess is a pus-filled cavity within the liver, commonly caused by amoebic infection (Entamoeba histolytica) or bacteria. Amoebic liver abscess is common in India, especially in young males. Most respond to antibiotics + drainage without surgery.
Causes
- Entamoeba histolytica (amoebic abscess — most common in India)
- Pyogenic bacteria (E. coli, Klebsiella, Streptococcus)
- Biliary infection (ascending cholangitis)
- Portal pyemia (from appendicitis/diverticulitis)
- Post-surgical/traumatic
- Cryptogenic (no identifiable source)
Risk Factors
- Poor sanitation and contaminated water
- Alcohol use
- Diabetes
- Immunosuppression
- Biliary disease
- Male gender (amoebic)
- Age 20-50 years
Symptoms
Diagnosis
- Ultrasound abdomen (first-line — shows cavity with internal echoes)
- CT abdomen with contrast (for complex/multiple abscesses)
- Blood tests (elevated WBC, liver enzymes, positive amoebic serology)
- Aspiration of pus (anchovy sauce = amoebic; foul-smelling = pyogenic)
- Blood cultures
Treatment Options
Surgical Treatment
Most liver abscesses are managed non-operatively with antibiotics + percutaneous drainage. Surgery is reserved for: ruptured abscess into peritoneal/pleural cavity, failed percutaneous drainage, left lobe abscess near pericardium (risk of cardiac tamponade), or when malignancy cannot be excluded. Dr. Bhagat performs laparoscopic drainage when needed.
Recovery
Percutaneous drainage: 5-7 days IV antibiotics, then oral for 2-4 weeks. Amoebic: luminal agent (diloxanide furoate) to prevent recurrence. Complete resolution on imaging in 3-6 months. Surgery if needed: 5-7 days hospital stay.
Prevention
- Safe drinking water
- Proper hand hygiene
- Treat intestinal amoebiasis promptly
- Control diabetes
- Treat biliary infections early
Frequently Asked Questions
Is liver abscess dangerous?
Will the liver recover completely?
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