Liver abscess is a condition when there is a buildup of pus in the liver due to infection. This disease needs to be treated by a doctor because it can cause dangerous complications that can be life threatening.
The liver is an important organ that has many functions in maintaining overall body health. This organ plays a role in producing bile and digestive enzymes, destroying toxins in the body, producing protein, processing cholesterol and bilirubin, and regulating blood clotting.
If the liver is infected, one of which is due to a liver abscess, this will certainly have an impact on the function of that organ.
Causes of Liver Abscess
Based on the cause, liver abscess is divided into three groups, namely:
Pyogenic liver abscess
Pyogenic liver abscess occurs when the liver is infected with bacteria, which triggers the formation of pus in the liver. Pus is a fluid consisting of white blood cells and dead cells that forms when the body fights infection. Liver abscess due to this bacterial infection can be caused by certain conditions or diseases, such as:
- Ruptured appendix, gastric leak, or diverticulitis.
- Infections, eg infection of the gallbladder and infection of the blood or sepsis.
- Cancer, such as pancreatic cancer, liver cancer, and colon cancer.
- Injury to the liver caused by an accident, such as a stab wound or blow.
- History of endoscopic procedures on the bile ducts.
Amoebic liver abscess
Amoebic liver abscess is rare. Amoebic liver abscess is caused by infection with the type of amoebic parasite E. histolytica. This parasite lives in soil or water, especially in tropical or subtropical climates, which are densely populated and have poor sanitation.
Amoebic infection occurs when the amoeba enters the body through the mouth or nose, as a result of not washing hands thoroughly after defecating or engaging in activities in a dirty environment. Before causing liver abscess, amoeba usually causes dysentery with symptoms of bloody diarrhea or mucus.
Fungal liver abscess
Apart from bacteria and parasites, liver abscess can also be caused by a fungal infection. However, cases of liver abscess due to fungi are quite rare. The type of fungus that often causes liver abscess is Candida fungus.
Fungal liver abscess is more at risk in people who have weak immune systems, such as people undergoing chemotherapy, having had organ transplant surgery, or suffering from HIV infection.
In certain cases, liver abscess can also be caused by parasitic worms Echinococcus granulosus. Liver abscess due to this worm infection can be caused by consumption of undercooked beef, pork, dog, or goat.
Symptoms and Risk Factors of Liver Abscess
The following are some of the symptoms that can appear due to a liver abscess:
- Pain in upper right abdomen
- Fever.
- Shivering.
- Frequent night sweats.
- Digestive disorders, such as nausea, vomiting, and diarrhea.
- Dark urine.
- The stool is white or gray.
- Drastic weight loss.
- Cough and right shoulder pain.
- Jaundice.
Liver abscess generally can affect anyone. However, a person is more at risk of developing a liver abscess if he has the following risk factors:
- More than 70 years old.
- Living in a dirty environment.
- Too often or consume too much liquor.
- Malnutrition or malnutrition.
- Undergoing certain medications, such as corticosteroids, chemotherapy, and PPIs.
- Diseases that cause a weakened immune system, such as diabetes, cancer, or HIV/AIDS.
If there are symptoms of a liver abscess along with the risk factors above, you are advised to immediately consult a doctor. To diagnose a liver abscess, the doctor will perform a physical examination along with other supports, such as blood tests, ERCP, as well as ultrasound, X-ray, and a CT scan or MRI of the liver.
Liver Abscess Treatment
Patients with liver abscess usually require hospitalization. During hospitalization, doctors can provide treatment in the form of antibiotics through an IV if the liver abscess is caused by bacteria. If the liver abscess is caused by a fungal infection, your doctor may prescribe antifungal medication.
If the liver abscess is severe and large or does not improve with treatment, the doctor may try several measures to treat the liver abscess, such as:
Drainage
Drainage or suction of pus fluid in the liver is done if the patient does not improve within 5-7 days after giving antibiotics. Drainage is classified as minimally invasive surgery.
This procedure is done by inserting a needle and catheter into the liver through the skin in the abdomen with the guidance of a CT scan or ultrasound. After the catheter and needle are in place, the doctor will drain the pus from the liver affected by the abscess.
During this procedure, the doctor may also perform a biopsy, which is a sample of liver tissue to be examined in a laboratory using a microscope. This biopsy may be done if the doctor suspects that the liver abscess is caused by liver cancer.
Operation
The surgical procedure is performed when the condition of the liver abscess is already severe. After surgery, the patient also still needs to receive antibiotic treatment to eradicate the bacteria that cause liver abscess.
If not treated immediately, liver abscess can cause complications in the form of sepsis and rupture of the pus bag. If the pus-filled sac in the liver bursts, germs can spread to other parts of the body and cause peritonitis and inflammation of the lining that covers the heart (pericarditis).
Complications of liver abscess is an emergency condition that needs to be treated immediately with appropriate treatment so as not to cause death. Therefore, you need to immediately see a doctor if you experience symptoms that are suspected of being a liver abscess.