Pyogenic liver abscesses — diagnosis and management

Summary

Pyogenic liver abscess is an uncommnon condition. Although potentially fatal, early appropriate treatment is often curative. Seven such patients presented to St. Vincent’s Hospital in two years. One patient died, one suffered severe brain damage from an associated cerebral abscess and five recovered fully. Four representative cases, who presented to the G.I. unit, are reported. These patients illustrate the characteristically non-specific presentation of this condition, the importance of early diagnosis and the problems of late recognition. A literature review shows that a variety of conditions and organisms are associated with liver abscess and confirms the need for early consideration of the diagnosis on clinical grounds. We suggest a simple approach to definitive diagnostic imaging when the condition is suspected and discuss the relative roles of antibiotics, interventional radiology and surgery in treatment.