Let’s move on to a discussion of pyogenic abscesses. Unlike amebic abscesses, these are secondary
to another infection. Whether it’s bacteremia or an abscess located somewhere else, it has gained
access to the systemic circulation with subsequent seeding of the liver. Once again, physical findings
for both abscesses are usually associated with right upper quadrant abdominal pain.
Because there’s an ongoing infection, the patient may also report fevers and chills.
In very severe cases, patients may present with septic shock, low blood pressure, and organ damage.
Routine chemistries may be normal. You may find an increased WBC or leukocytosis.
There are variable changes in the liver function test. Here’s a CT scan demonstrating
a liver abscess in the left lower of the lobe. Take a look at the black arrow.
For amebic abscesses, the treatment is usually metronidazole or commonly known as Flagyl.
For pyogenic, this usually requires drainage and antibiotics. I remember because
pyogenic abscesses may be related to a secondary infection elsewhere. Of course, treatment
of the secondary infection is also very important. Remember some of the important
clinical pearls. Hepatic adenomas are at risk for rupture and can cause significant bleeding.
In these patients, surgery is usually recommended. For your test, hepatic adenomas
are associated with oral contraceptives, whereas the other benign tumors are not.
Thank you very much for joining me on this discussion of benign liver tumors.