A liver abscess is a local collection of pus in the liver, often caused by infection. It may develop after the injury to the liver or due to spreading through the bloodstream, especially due to the spread of the portal vein. The most common types are piogenic (bacterial) and amybic (parasitic) liver boils. Less commonly, fungi or parasites such as echinococcus liver cysts that can mimic boils

INDITODAY. Dr. Talked with Sanjeev Rohtgi, advisors – surgical gastroenterology and multi -organ transplantation, Manipal Hospital, Whitefield get more inputs on this critical condition.

“Liver abscess can only be dangerous as hepatitis or cirrhosis, but it does not always shout to pay attention,” Dr. Rohtgi explains. “Sometimes symptoms occur in vague muscle pain, loss of appetite, or normal malaise, but other times the infection collides with high fever and cold.”

Although relatively rare, liver boils can be life-threatening if untreated, with a significant risk of mortality. Initial diagnosis and proper management are necessary to improve the results.

Causes and risk factor

Piogenic liver boils infections of bacteria such as e. Coli arise from Clabsialla pneumonia, streptococcus and staphylococcus. Common sources include biliary tract diseases (stone, strictness), collangitis, appendicitis, diverticulitis or trauma.

• Amibic liver abscess is caused by the antamoeba histolytica, which initially infects the intestines and later spreads to the liver.

• Rarely, echinococcus gives rise to hydrated ulcer liver lesions caused by granulosus (a tapworm).

• Risk factors include diabetes, male sex, age 40–60, immunocomosis condition and existing liver or bile disease.

Signs and symptoms

• High fever with cold (90% cases)

• Right upper abdominal pain or tenderness (50-75%)

• Branical

• Nausea, vomiting, and loss of appetite

• Jaundice in some patients

• Weight loss and fatigue

• Rarely, Clabciela infection causes septic embellies to affect the eyes or brain

Dr. “The pain often dwells just below the ribs where the liver sits. Tenderness is an important clue for physicians,” says Rohtgi.

Clinical approach

• Blood tests: Excessive white blood cells, liver enzymes, inflammatory markers and blood cultures to detect bacteria.

• Imaging: Ultrasound is the first step, which reflects cystic lesions. Contrast-eneensed CT scan provides more detailed images.

• Sirology: Antibody test for Antamoeba Histoltique, for amybic abscess. For hydated cysts, Echinococcus for Echinococcus.

• Aspiration: The directed needle provides pus for aspiration culture and organism, important for targeted therapy.

• “The easiest and fastest way to confirm a liver abscess is with an ultrasound, which can later be done to look closely for a CT scan,” Dr. Rohtgi explains.

Treatment

• Drainage: percutaneus catheter drainage is preferred for large boils from 5 cm under ultrasound or CT guidance. Small abscesses can be treated alone with a needle aspiration.

• Antibiotics: Broad-spectrum antibiotics are combined with metronidazole for hemibic infection. Treatment varies from 2 to 6 weeks depending on severity.

• Surgery: Broken boils, thick-walls or several boils, or reserved for cases reserved for cases refractory.

• Antipercetic therapy: Albendazole for hydrated cysts with surgery or drainage in complex cases.

Case study: Anil Dhawan’s visit with liver abscess

Anil Dhawan, a 51 -year -old man, also experienced high fever and severe shortness of breath to get fresh air. Concerned about his worsening condition, he reached BLK Kapoor Hospital in Rajendra Place. Blood tests detected a high total leukocyte count (TLC), signaling infection. After immediate ultrasound, a CT scan detected several big boils in her liver. The doctor recommended immediate drainage to prevent the boils from spreading further. Anil gradually poured Perkutenius drainage with 3 to 4 catheters to empty pus. After 15 days of hospitalization and antibiotic treatment, Anil was well recovered and discharged.

Role of registered health information administrator (RHIA)

To manage cases of liver abscess requires coordinated care between many health professionals – physicians, radiologists, infectious pathologists, surgeons, nurses and pharmacists. Riya plays an important role:

• Maintaining accurate, wide patient records for diagnosis, treatment and results.

• To ensure proper coding and documentation for liver abscess cases to support clinical decisions and billing.

• Communication facility between teams to improve care coordination and patient safety.

• Helping data collection for clinical audit and quality improvement related to liver abscess management.

“Rhia supports the healthcare team by ensuring information accuracy and availability, which is important for timely and effective liver abscess care,” Dr. Rohtgi says.

Prevention and precautions

• Practice good hygiene and hygiene.

• Drink clean, safe water to avoid parasitic infections.

• Treat stomach infection and bile diseases immediately.

• Manage chronic diseases like diabetes.

• Avoid exposure to animal stool or saliva to prevent hydrated disease.

• If fever or abdominal pain develops, pay early medical attention.

Potential complications

• Peritonitis

• Septic embroidery

• Repetition, especially in bile path diseases

• If the abscess stops, chronic pain or internal fever

Later complexity after treatment of liver or kidney failure

Fasting – liver boil

Question: What is the cause of a liver abscess?

A: Antamoeba histolytica is the primary cause such as bacterial infection (piogenic) and parasitic infections. Risk factors include bile disease, diabetes and immunological conditions.

Question: What are the symptoms?

A: High fever, chills, right upper abdominal pain, nausea, vomiting, and sometimes jaundice and shortness of breath.

Question: How is it diagnosed?

A: Blood test, ultrasound, CT scan, serology, and boil fluid needle aspiration.

Question: How is it treated?

A: Foba plus drainage of targeted antibiotics or antipercritic drugs.

Question: Can it be stopped?

A: Yes, with early treatment of good hygiene, safe drinking water, and infections.

“Whether struggling with an infection such as providing a second chance in life through a liver abscess or organ donation, both remind them how difficult the human body is and how much we can do to defend and give it,” Dr. Rohtgi said.