Liver Abscess
A liver abscess is a pocket of pus that forms as a result of injury to the liver. If left untreated, it can develop into an infection. Pus itself is made up of white blood cells and dead cells that form when the body tries to fight an infection.
The pus should flow out of the liver. However, the pus actually accumulates in pockets in the liver. The presence of pus will trigger swelling and inflammation in the area around the liver so that pain in the area around the stomach cannot be avoided.
Symptoms of Liver Abscess
There are some common symptoms experienced by liver abscess sufferers. Some of them can develop into more severe if not treated properly. Here are some symptoms to watch out for:
1. Fever and chills.
2. Pain in the upper right abdomen.
3. Decreased or loss of appetite.
4. The body feels weak.
5. Coughing or hiccups due to irritation of the diaphragm.
6. Weight loss.
7. The stool is reddish-black in color.
8. Dark colored urine.
9. Diarrhea.
10. Pain in the joints.
11. Nausea with or without vomiting.
12. Pleurisy that causes difficulty breathing.
13. Sweating a lot.
14. Jaundice is characterized by yellowing of the skin and whites of the eyes.
Risk Factors for Liver Abscess
There are several risk factors that can increase the risk of developing a liver abscess, including:
- Old age.
- Male gender.
- Have diabetes mellitus.
- Have cirrhosis or hardening of the liver.
- Having Crohn’s disease, which is a chronic inflammatory bowel disease that affects the lining of the digestive tract.
- Having a stomach or gastrointestinal infection.
- Had abdominal surgery recently.
- Undergoing gallbladder endoscopy.
- Alcoholism or heavy alcohol consumption.
- Having a disease that disrupts the body’s immunity, such as HIV or AIDS.
- Undergoing an organ transplant or cancer treatment.
- Taking corticosteroid drugs.
- Have poor nutritional status.
Causes of Liver Abscess
Liver abscess disease occurs when a pus pocket develops in the liver due to infection. Liver abscesses are divided into three categories based on the underlying cause, namely:
- Pyogenic liver abscess: This abscess is caused by a bacterial infection. “Pyogenic” means ‘producing pus’. The infection spreads directly from structures near the liver, such as the bile duct, or from the appendix. The bloodstream can then carry the infection from more distant parts of the body.
- Amoebic liver abscess. The cause is the entamoeba parasite. The parasite can travel from the intestines, through the bloodstream to the liver. In rare cases, other organisms or fungi can also cause liver abscesses.
- Liver abscess caused by injury. Surgery, diagnostic procedures, or trauma to the liver can cause a liver abscess.
This disease is generally triggered by germ, bacterial, parasitic, or fungal infections. Some types of pathogens that trigger it are:
- Bacteria, namely Escherichia coli and Klebsiella pneumoniae.
- Amoeba, namely Entamoeba histolytica.
- Fungi, namely Candida sp.
- Appendix.
- Diverticulitis, which is an infection of the pouches along the large intestine (colon).
- Cholecystitis, which is inflammation of the gallbladder.
In addition, infection can also occur when:
- Inflammation spreads to the liver from the gallbladder, bile duct, or appendix.
- Pathogens flow into the bloodstream to the liver from other nearby organs.
- Post-operative or have had liver injury.
Liver Abscess Diagnosis
The diagnosis process is carried out by a specialist doctor based on the results of the interview and complaints experienced by the sufferer. Then, the doctor continues the diagnosis process by conducting a physical examination and other supporting examinations. Here are some supporting examinations that are carried out:
- Complete blood count, which is done to determine the number of red blood cells, white blood cells, and platelets in a person’s body.
- Liver function tests, which are performed by checking blood enzyme and protein levels to determine the condition of the liver.
- Blood culture, which is a diagnostic test to detect the presence of bacteria, fungi, or parasites in the liver.
- Abscess fluid culture, which is done to detect the bacteria that cause pyogenic liver abscess.
- X-rays, which are performed using electromagnetic radiation to produce images of the required body parts.
- Ultrasonography (USG), which is performed using high-frequency sound wave technology to display images of the required body parts.
- Computerized tomography scan (CT scan), which is done by combining X-ray technology and a computer system to display images of the required body parts.
- Fine needle aspiration, which involves inserting a fine needle through the skin to remove a sample of fluid or tissue.
- Percutaneous catheter drainage, which is done by inserting a catheter to drain fluid that has accumulated in the liver.
Liver Abscess Treatment
In mild to moderate intensity, sufferers can improve within 2 weeks after taking medication and pus removal procedures. If the cause of the abscess is triggered by amoeba, then the sufferer will experience a mild fever for 4-5 days.
In addition to taking antibiotics as recommended by the doctor, sufferers must adopt a healthy lifestyle, wash their hands diligently, and regularly check themselves with a doctor. If the abscess occurs in severe intensity, surgery is recommended. However, if the sufferer has an unstable body condition to undergo surgery, antibiotic therapy is recommended.
Every treatment process certainly has its own side effects, including antibiotic therapy. The side effects felt depend on the type of drug given. Therefore, before being prescribed, you should tell your doctor if you have a history of allergies to drugs.
Liver Abscess Prevention
Liver abscesses caused by infection or inflammation of other organs can be prevented by taking the following steps:
- Maintain cleanliness.
- A regular diet and lifestyle, so that the body’s immune system is always maintained.
- If you have a disease, immediately see a doctor and treat it until you are completely cured.
- Avoid unnecessary consumption of alcohol and drugs.
Liver Abscess Complications
Liver abscess sufferers triggered by bacteria are at high risk of losing their lives if not treated immediately. Here are some conditions that are complications of liver abscess:
- Abscess rupture, which is the rupture of a pus sac.
- Sepsis, which is extreme inflammation due to a life-threatening infection.
- Peritonitis, which is inflammation of the thin membrane that lines the inner abdominal wall and the organs within it.
- Empyema, which is a buildup of pus in the space between the lungs and the chest wall.
- Endophthalmitis, which is inflammation inside the eyeball due to an infection that has developed.