KTPH Hepato–Pancreato–Biliary Surgery Service (HPB)

Liver Abscess

A liver abscess is a collection of infected fluid and dead tissue in the liver caused by an infection. If the abscess is very small and the organism causing it has been isolated from a blood culture, it may be treated with a course of antibiotics alone. Most liver abscesses >4cm will require needle aspiration or drainage tube placement as a procedure by Interventional Radiology. This allows both the removal of the infected fluid and a culture of the fluid to guide the choice of antibiotic. Cultures of the fluid will be sent for Gram stain, aerobic and anaerobic culture. Larger abscesses may require repeat percutaneous drainage procedures, and non-resolving abscess may require reimaging and biopsies to exclude malignancy

Most patients will require a PICC (long-term use peripherally inserted central catheter) for OPAT (outpatient antibiotic treatment) inder the care of the Infectious Disease team - usually about 4-6 weeks. The drain tube may be left in place to remove infected material from the abscess when you return home and you will be instructed on its care - it will be removed when the drainage is minimal and ther is no purulent material or bile in the tubing ~ usually about 7 days. Additional studies (Tubogram, Ultrasound or CT) may be used to evaluate for damage by the abscess to nearby structures, to follow the improvement and guide the completion of antibiotic therapy along with blood tests looking at markers for infection.

Certain types of bacterial infections require additional screening for infections of the eye (endopthalmitis) or endoscopy of the stomach and colon to exclude cancerous growths.