Complications caused by liver abscess

The article was professionally consulted by Doctor Vo Thi Thuy Trang, Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital

Liver abscess is the formation of a pus-filled cavity due to the destruction of liver cells, causing many serious complications. The pus-filled fovea can appear singly or multiple foci of different sizes. So what complications can liver abscess cause and how dangerous?

Liver abscess is one of the relatively common bacterial infections in the hepatobiliary system in Vietnam. In general, the cause of this disease can be bacterial, fungal, parasitic, or secondary to related diseases and some other external influences. There are two main and typical types of liver abscess including:
Amoeba liver abscess: Countries with tropical and subtropical climates are suitable places for amoeba development due to poor living conditions. Amoebic liver abscess mainly occurs in the colonic intestine, with the risk of passing from the mucosa into the portal vein. The disease is transmitted by the fecal-oral route, in rare cases, the amoeba will pass through the intestinal wall to the liver, causing liver abscess. This is the most common type of abscess, accounting for 80% of all patients with liver abscess in Vietnam.
Bacterial liver abscess: This type of abscess is rare in our country but quite common in Europe. The disease is caused by bacteria that invade the liver, causing inflammation and necrosis of liver cells, creating a pus or many abscesses in the liver. Bacterial liver abscesses almost always occur secondary to internal organ infections, liver biopsies, or even in some cases no cause can be found.

Symptoms: Patients with liver abscess often experience symptoms such as abdominal pain in the liver and spreading to the right shoulder, fluctuating fever, night sweats, digestive disorders, cough, shortness of breath, jaundice, etc. .. In which, acute manifestations appear when multifocal liver abscesses, single-focal liver abscesses often progress slowly. Diagnosis will be based on clinical and laboratory symptoms, as well as patient history.
Treatment: The treatment of common liver abscess is the antibiotic metronidazole alone or in combination to destroy the amoeba. Purulent aspiration combined with drugs in cases of ineffective medical treatment. Indications for catheter drainage are increasingly narrow, while surgical measures are limited to some cases of liver abscess complications with serious signs. In addition, the use of pain relievers, fluids and nutritional supplements will also be conducted in the supportive treatment of patients with liver abscesses.

Complications of liver abscess are mainly due to the rupture of the abscess into the adjacent structures, such as:
Rupture into the lung and pleural space: When the abscess at the top of the right liver ruptures, it will cause perforation of the diaphragm and burst directly into the lung, causing the patient to vomit pus or spit out pus; Pericardial rupture: Symptoms similar to heart failure or cardiac tamponade are very dangerous, if not promptly intervened, there is a risk of death due to acute cardiac tamponade; Intra-abdominal rupture: A common complication is generalized peritonitis, if delayed intervention has the risk of death due to septic shock; Rupture into the gastrointestinal tract: The rupture into the stomach causes the patient to vomit pus and blood; rupture into the colon, causing prolonged purulent and bloody defecation; There are cases of rupture into the abdominal wall and leak out of the abdominal wall but rarely. In addition, a number of other complications of liver abscess are: prolonged pustulosis, widespread infection and liver abscess caused by superinfected amoeba. Bacterial liver abscesses have similar complications as amebic liver abscesses. However, thanks to modern diagnostic tools today, these complications are rarer because liver abscesses are detected very early.

In general, liver abscess can cause many dangerous and even life-threatening complications if the patient is treated late. But over the past three decades, advances in diagnostic and imaging studies have reduced the mortality rate of bacterial liver abscesses from 9-80% to 5-30%. There are also statistics that suggest that rapid diagnosis and effective treatment have reduced the mortality rate from amoebic abscess to only 1-3%. On the other hand, some factors have an adverse effect on the patient's prognosis including shock due to hypotension, acute renal failure, and acute respiratory failure.
Liver abscess is a rather dangerous disease, but the prevention is extremely simple. For individuals and communities, keeping the environment and lifestyle hygienic, using clean water, eating cooked food, drinking boiling water, ensuring food safety, etc., can prevent infection and amoeba causes liver abscess.
Doctors also confirm that thanks to the development of medicine, modern imaging methods and effective antibiotics, have helped diagnose and treat bacterial liver abscesses and liver abscesses. amoeba is better controlled, the mortality rate is significantly reduced.
Specialist Doctor I Vo Thi Thuy Trang is trained in gastroenterology, hepatobiliary tract and gastrointestinal endoscopy; continuously updated and received advanced endoscopic training from professors and endoscopy experts from Switzerland and Japan; participated in many domestic and international gastroenterology and endoscopy conferences.
With nearly 20 years of working at Da Nang General Hospital in the field of gastrointestinal endoscopy - hepatobiliary disease, every year, Doctor Vo Thi Thuy Trang participates in endoscopy more than 1500 cases including: endoscopic diagnosis of diseases stomach, colon such as: detecting inflammation, ulcers, polyps, cancer, finding HP bacteria, detecting cancer early in the digestive tract...; Endoscopic treatment such as: Hemostasis in gastrointestinal bleeding, esophageal varices ligation in cirrhosis, endoscopic gastrointestinal polypectomy...