| Theme | Liver in Infection Diseases | |
|---|---|---|
| Title | Etiology and Treatment of Pyogenic Liver Abscesses | |
| Publish Date | 2001/04 | |
| Author | Shigeki Hayashi | Department of Gastroenterology, International Medical Center of Japan |
| Author | Hiroko Yamashita | Department of Gastroenterology, International Medical Center of Japan |
| [ Summary ] | For the treatment of pyogenic liver abscesses, it is very important to know both the most common route of infection and the responsible microorganism. The leading route of infection in pyogenic liver abscesses is through the biliary tract, followed by the portal vein. Other routes, such as through the hepatic artery, direct extension and cases of abdominal trauma, are quite rare. Gram-negative bacilli, such as Klebsiella pneumoniae and Escherichia coli are often detected in infected bile. After the introduction of systemic administration of appropriate antibiotics and ultrasound-guided percutaneous transhepatic abscess drainage (US-PTAD), the mortality rate has decreased to nearly zero. There is still some controversy as to when administration of antibiotics should be stopped, and in to what size of abscess US-PTAD should be introduced. Controlled trials should be performed to answer these questions. |
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