This article will focus on the problem of a liver abscess. But before we look at what can go wrong, let’s see what the main functions of the liver are:
What is the role of the liver in our body?
The liver is the largest gland of our body. It makes up 2.5% of our body weight. The location of this organ is at the upper right quadrant of the abdomen. This is close to the right lung, which is just below our diaphragm (breathing muscle under the ribs).
The liver’s function is to cleanse our system, detoxify and eliminate toxins. The organ is very rich in veins that supplies blood and oxygen to it. Any blockage in any of the blood passages will cause liver enlargement and malfunction. It aids in digesting and absorbing nutrients. In addition, the liver is also responsible for our body’s metabolism. It regulates the sugar levels in our blood. So the liver does a lot!!!
Like other organs, the liver can also be affected by infection. An abscess is a kind of localized infection (only a small area is initially affected) wherein there is a formation of pus and other harmful substances enclosed in a capsule. However, it can spread to nearby organs causing a much more serious inflammation.
What causes an abscess in the liver?
In a liver abscess, the infective capsule contains pus and other substances like blood, fluids and the causative micro-organisms. The other factors contributing to the formation of liver abscess are:
The blue swelling is an amebic liver absess
- Blockage – any obstruction in the veins or in the passageway of bile (fluid produced by the liver to digest fats) can cause liver abscess. In addition, presence of stones or kinking (of veins) will narrow the passageways, causing malfunction. Trauma may cause blockage.
- Organisms – bacteria passing through the veins, affecting the organ. Bacterial infection causes pyogenic liver abscess, the most common form. Another harmful organism is the amoeba (amebic abscess), causing not only infection, but other liver problems (such as poor digestion) as well. Fungal infection is a third type.
- Existing medical conditions – cancer, diabetes, liver cysts and diverticulitis (disease of the large intestine where there are pouches). Infections in nearby areas. These medical illnesses weaken the immune system and thus the protection is low.
Signs of this problem
The signs and symptoms of liver abscess include:
- Pain– usually present in the upper right section of the abdomen (where the liver is located), and right shoulder pain can also be noted.
Pain is a common symptom of a liver abscess
- Liver enlargement – is assessed through palpating and observing the abdomen. Tenderness is noted. An increase in abdominal girth is indicative of enlargement. Sensation of heaviness or fullness is noted. When the liver is enlarged, it can press on the lung (specifically the right lung). Breathing may be difficult and right pleural effusion (accumulation of fluids in the lungs) may occur.
- Weight loss – due to pain and other discomfort brought about by the infection, the appetite is affected. Nausea and vomiting may be present. With this, the electrolytes and nutrients from the food we eat are lost.
- Fever – an elevation in body temperature (above 98.6 °F or 37°C) is noted due to the infection present. Due to fever and altered body functioning, diaphoresis (excessive sweating) may occur.
- Other signs include clay-colored stool, dark urine and jaundice.
Diagnostic tests
A liver abscess is internal, therefore, diagnostic tests are needed for confirmation of the exact problem:
- Liver scan – An allergy test is performed first prior to the procedure. Once allergy is not known, a needle is inserted directly to the liver to administer a radioactive substance that helps in viewing of the entire liver. This is another kind of imaging test, determining the size, shape, presentation and morphology (how the organ looks like). Any growths or enlargement is noted. This scan also checks for the function of the liver.
- Ultrasound – provides an image of the region to determine growths and assess if there are any changes.
- CT(Computer Tomography) scan of the area – a kind of imaging test, wherein it prints out horizontal and vertical slices of the organ. This locates the specific area of the liver where the abscess can be found.
Bacterial cultures may be needed in diagnosis of liver abscess
- Arteriography – a dye (substance) is injected to aid in viewing of the veins and arteries of the liver. This is to check how the blood flows in the blood channels. In addition, any blockage (such as stones, blood clots) or any twists in the veins or arteries are detected.
- Blood tests – noting for the liver enzyme levels, and bilirubin (high levels mean obstruction). Blood tests are ordered by the doctor to check for the deviancy from the normal range. This is also to check your liver function.
- Blood culture – a kind of blood test, specifically designed to determine the causative organism of the infection. Blood culture aids the physician in prescribing medications to the patient. This test determines the medicines that the organism is sensitive to.
Apart from these tests, physical examination is performed by the physician by assessing the vital signs (blood pressure, temperature, breathing, pulse rate and pain levels). In addition, body weight and abdominal circumference are documented. Assessment is very important, in order to determine any deviances from the normal values.
Home Care Tips
Upon confirmation of the liver abscess, this is what we can do at home to alleviate us from pain and other discomfort:
- Exercise – movement will promote good blood circulation as well as prevent lung complications. Coughing and deep breathing exercises also help. This will aid in lung expansion.
- Increase fluid intake – to prevent dehydration (vomiting will result in electrolyte loss and this is one way to replace it).
- Skin care – fever and excessive sweating are noted with severe infections. Therefore, skin care is a must to keep our first line of defense intact. Change clothes frequently and perform sponge bath to lower down temperature.
- Hygiene – practice good hygiene by washing hands frequently, especially after bathroom use to prevent spread of disease.
Medical Treatment of Liver Abscess:
- Percutaneous drainage– a small needle is inserted in the area where the abscess can be drained. This is with the aid of one of the imaging tests mentioned above. When a wire is placed as a guide, a needle with syringe will be inserted in the area with the wire to obtain the pus from the liver. This drainage is the non-invasive form of pus removal.
Syringe for needle aspiration in abscess drainage
- Surgical drainage of large abscesses – usually done under general anesthesia. A mask is secured in the facial area to release sedating gas, putting the patient to sleep. An incision will be made and the pus is removed carefully, avoiding the pus-filled capsule from rupturing.
- Antibiotic treatment – to specifically target micro-organisms that caused the infection. During the first treatment, the doctor may administer medications through the vein for faster effect. Through the course of the treatment, oral antibiotics in capsule or tablet form will be prescribed.
The problem of liver abscess is one that is preventable. However, when we acquire it, there are effective treatments available. Early diagnosis and treatment result in faster recovery and reduced mortality rate. So seek early help if you have any concerns.
