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 multiorgan failure.
Rare complication. Presents with acute epigastric pain and vomiting.
Patients with underlying biliary disease have the highest rate of recurrence (25%).[66] Potential etiologies 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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