Complications
Patients may have symptoms of diaphragmatic irritation, such as referred right-sided shoulder tip pain, cough, or hiccups.
Patients may present with a cough that is productive of purulent sputum. Metallic-tasting sputum has been reported.[77]
Due to erosion of the abscess into the vascular wall of the hepatic artery.
Diagnosed with computed tomography angiogram.
Requires surgical management.
Demonstrated on contrast-enhanced computed tomography (CT) scan.
One trial that performed CT scans on patients with liver abscess over a 5-year period demonstrated venous thrombosis in 42% of patients; 24% of patients had thrombosis involving the portal vein, and 22% had thrombosis involving the hepatic vein; 4% of patients had both portal vein and hepatic vein thrombosis.[81]
More common in people with pre-existing liver disease or those with a particularly large area of abscess involvement in the liver.
May occur in association with acute sepsis and multi-organ failure.
Rare complication. Presents with acute epigastric pain and vomiting.
Patients with underlying biliary disease have the highest rate of recurrence (25%).[66] Potential aetiologies include biliary obstruction and a fistula between the biliary tree and the intestine. If a liver abscess recurs, the authors would recommend that expert consultation by a gastroenterologist and investigation for biliary abnormalities by endoscopic retrograde cholangiopancreatography or magnetic resonance cholangiopancreatography should be considered.
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