Reasons why liver abscesses do not liquefy

Written by Zhang Wei Wei
Integrative Medicine
Updated on September 10, 2024
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The reasons for the non-liquefaction of liver abscesses, in my opinion, are several. The first is that the abscess is very large, and the second is the inappropriate use of antibiotics. So, what can we do to solve this problem? Firstly, liquefaction of a liver abscess takes time, and it is difficult for a large abscess or a single large abscess to be absorbed on its own. Therefore, it requires combining with percutaneous drainage. Often, even if the abscess has not fully liquefied, fine needle aspiration can still be performed to extract the pus for culture, and then identify the sensitive antibiotics. After administering a sufficient amount and course of the sensitive antibiotics, the liquefaction of the liver abscess can be accelerated and the pus can be expelled sooner.

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Written by Zhang Wei Wei
Integrative Medicine
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Reasons why liver abscesses do not liquefy

The reasons for the non-liquefaction of liver abscesses, in my opinion, are several. The first is that the abscess is very large, and the second is the inappropriate use of antibiotics. So, what can we do to solve this problem? Firstly, liquefaction of a liver abscess takes time, and it is difficult for a large abscess or a single large abscess to be absorbed on its own. Therefore, it requires combining with percutaneous drainage. Often, even if the abscess has not fully liquefied, fine needle aspiration can still be performed to extract the pus for culture, and then identify the sensitive antibiotics. After administering a sufficient amount and course of the sensitive antibiotics, the liquefaction of the liver abscess can be accelerated and the pus can be expelled sooner.

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Written by Zhang Wei Wei
Integrative Medicine
1min 5sec home-news-image

Can a liver abscess cause ascites?

Can liver abscess cause ascites? Some liver abscesses can cause ascites. Firstly, it must be understood why ascites occur. It is because the patient has poor resistance, internal infections, and is prone to worsened infections. A liver abscess involves significant energy consumption due to prolonged fever and intermittent fevers, which can reduce the liver’s capacity to synthesize albumin, leading to a decrease in colloid osmotic pressure within the blood vessels. This is accompanied by the formation of fluid accumulation in the abdominal cavity. Therefore, when a patient with a liver abscess develops ascites, there is no need to be overly anxious or nervous. Treatment can involve vigorous anti-infection measures, supplementation with albumin, and other supportive treatments to improve the symptoms and alleviate the patient's ascites, facilitating a quicker recovery.

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Written by Zhang Wei Wei
Integrative Medicine
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Clinical manifestations of liver abscess

Clinical manifestations of liver abscess include irregular, purulent fever, especially noticeable in bacterial liver abscesses. The fever is irregular and typically high, preceded by chills, followed by persistent pain in the liver area, which worsens with deep breaths or movement. Depending on the location of the abscess, it can lead to corresponding respiratory and abdominal symptoms, often with a history of diarrhea. If the abscess ruptures, it can evolve into purulent peritonitis with pyothorax. Special signs include liver enlargement, and in the intercostal space corresponding to the abscess, there's localized edema and clear tenderness. Some patients may exhibit jaundice. If the abscess breaks into the chest cavity, lung abscesses can occur, or if it perforates into the abdominal cavity, peritonitis may develop.

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Written by Zhang Wei Wei
Integrative Medicine
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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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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.