| Abstract: |
Worldwide, the most common type of liver abscess is amebic abscess, which is caused by Entamoeba histolytica, a protozoan parasite. In the industrialized coutries, amebic liver abscess is rare, and more liver abscesses are pyogenic (caused by bacterial infection). This chapter on amebic and pyogenic liver abscess is from a textbook that familiarizes the reader with various imaging modalities, the information they provide, and the merits of each, in order to facilitate the combined use of different imaging techniques in the diagnosis and management of hepatobiliary (liver and bile tract) diseases. As medicine has progressed, the incidence of pyogenic liver abscess has been reduced, and the primary foci from which infection spreads to the liver have also undergone considerable changes. In developed countries in which there is no amebic dysentery, amebic abscess does occur sporadically, and it is frequently mistaken for pyogenic abscess. With current imaging methods, abscesses are easily detected, and early diagnosis and treatment have vastly improved the prognosis. The mortality rate associated with liver abscess, which was previously 70 percent, has been reduced to less than 10 percent in developed countries. The prognosis largely depends on the primary infection causing the pyogenic liver abscess, and on the complications arising. The most common current source of infection for pyogenic liver abscess is biliary tract disease, particularly cholangitis (gallbladder inflammation), a common complication of gallstones. The author reviews bacteriology, pathogenesis and pathology, epidemiology, clinical features, imaging techniques, treatment options, complications, and prognosis. 13 figures. 1 table. 40 references. |