Treatment of liver abscess

Written by Zhang Wei Wei
Integrative Medicine
Updated on September 16, 2024
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The treatment of liver abscesses is divided into medical and surgical treatment. Medical treatment mainly involves antibiotic therapy. For bacterial liver abscesses, especially during the acute phase when the inflammation is localized and an abscess has not yet formed, or there are multiple small abscesses, aggressive conservative medical treatment should be given. This involves the use of high doses of antibiotics and general supportive therapy to control the absorption of inflammation. The second method is antibiotics combined with percutaneous puncture drainage. For a single, larger liver abscess, aspiration of pus can be performed under ultrasound guidance. After aspirating as much pus as possible, antibiotics can be injected into the abscess cavity, followed by repeated punctures over several days, or a tube can be placed to drain the pus. When the abscess shrinks and the fluid output decreases, the tube can be removed. The third method is antibiotics combined with surgical drainage. For larger liver abscesses that have a potential to rupture and cause complications such as acute peritonitis and pyothorax, surgical incision and drainage should be performed urgently, alongside the use of systemic antibiotics. The fourth approach is antibiotics combined with surgical resection. For chronic liver abscesses, or those whose abscess walls do not collapse after drainage, leaving a dead space, or with sinus tracts that continually discharge pus without healing and where liver lobe destruction is severe with loss of normal functions, hepatic lobectomy can be performed.

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Written by Zhang Wei Wei
Integrative Medicine
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What should I do if a liver abscess ruptures?

Firstly, we must keep our emotions stable, avoid being nervous, avoid anxiety, and avoid shouting loudly, as these can increase the likelihood of bleeding. Do not excessively increase the pressure in the abdominal cavity. So, what treatment methods do we have? There are two types of treatments: surgical and non-surgical. If the patient has a mild liver rupture and stable vital signs without persistent active bleeding, treatment can be administered through blood transfusion, fluid infusion, hemostasis, antibacterial drugs, and hepatoprotective drugs. However, it is crucial to closely monitor the patient's vital signs and regularly review the imaging studies of the condition. We must diligently observe any changes in the patient's condition. If evidence of active bleeding occurs during conservative treatment, then surgical intervention must be immediately performed.

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Written by Zhang Wei Wei
Integrative Medicine
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Liver abscesses are treated in the Department of Hepatology.

This is likely a common and frustrating issue for many patients who visit this hospital on a daily basis. As the name suggests, liver abscess is related to the department of hepatobiliary sciences. It can also be looked into by other departments linked to the liver, such as hepatology, infectious disease department, and even the department of traditional Chinese medicine. No matter which department you visit, you can initially undergo some routine blood tests, abdominal ultrasound, CT scans, etc., to determine the size and scope of the liver abscess, check whether it has ruptured or caused any bleeding. Subsequently, based on the doctors' initial diagnosis, you can be referred to the relevant department. If surgery is needed, the patient should visit the department of hepatobiliary surgery. If surgery is not necessary, the departments of infectious diseases, hepatology, or traditional Chinese medicine are all viable options.

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Written by Zhang Wei Wei
Integrative Medicine
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Is a liver abscess serious? How is it treated?

If acute abdomen and peritonitis caused by liver abscesses, rupture, hemorrhage, or pyothorax, etc., liver abscesses are relatively severe. In these cases, the first steps should be the use of adequate antibiotics for a sufficient course, along with systemic supportive therapy, then controlling the inflammation and promoting the absorption of the inflammation. For conditions like rupture of liver abscesses or severe damage to the liver lobes that results in loss of normal function, surgical removal may also be considered. Additionally, for large liver abscesses that have perforated, causing peritonitis, pyothorax, or cholangiogenic liver abscess, while using systemic antibiotics, actively incising and draining the abscess should be considered. (Please use medications and treatment under the guidance of a doctor.)

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Written by Zhang Wei Wei
Integrative Medicine
1min 55sec home-news-image

Treatment of liver abscess

The treatment of liver abscesses is divided into medical and surgical treatment. Medical treatment mainly involves antibiotic therapy. For bacterial liver abscesses, especially during the acute phase when the inflammation is localized and an abscess has not yet formed, or there are multiple small abscesses, aggressive conservative medical treatment should be given. This involves the use of high doses of antibiotics and general supportive therapy to control the absorption of inflammation. The second method is antibiotics combined with percutaneous puncture drainage. For a single, larger liver abscess, aspiration of pus can be performed under ultrasound guidance. After aspirating as much pus as possible, antibiotics can be injected into the abscess cavity, followed by repeated punctures over several days, or a tube can be placed to drain the pus. When the abscess shrinks and the fluid output decreases, the tube can be removed. The third method is antibiotics combined with surgical drainage. For larger liver abscesses that have a potential to rupture and cause complications such as acute peritonitis and pyothorax, surgical incision and drainage should be performed urgently, alongside the use of systemic antibiotics. The fourth approach is antibiotics combined with surgical resection. For chronic liver abscesses, or those whose abscess walls do not collapse after drainage, leaving a dead space, or with sinus tracts that continually discharge pus without healing and where liver lobe destruction is severe with loss of normal functions, hepatic lobectomy can be performed.

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Written by Zhang Wei Wei
Integrative Medicine
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Does liver abscess have a connection with drinking alcohol?

Patients with liver abscesses are prohibited from drinking alcohol, because the main component of alcoholic beverages is ethanol, which needs to be metabolized by the liver and directly damages it. Excessive drinking can exacerbate the burden on the liver, worsening the condition. Therefore, patients with liver abscesses must absolutely avoid alcohol. If a patient insists on drinking, they should only do so in moderation three months after the abscess has healed. However, it is generally advised not to drink at all. It is beneficial for the liver if patients consume fresh vegetables and fruits and maintain a light diet, avoiding greasy and rich foods. This diet can also prevent the adhesion and aggregation of platelets, reduce the decline in white blood cells, and promote blood circulation and dispel stasis.