An abscess is a collection of pus in a wound that is generally caused by a bacterial infection. This condition can occur in any part of the body, including organs that play an important role in the body's metabolism, namely the liver. Abscesses that occur in these organs are known as liver abscesses or liver abscesses.
The liver plays an important role in producing bile and enzymes to help digest food, and eliminate toxins that enter the body such as alcohol. Disorders of these organs, including liver abscesses, will certainly interfere with the process.
Detection of liver abscess can be known from physical examination and supporting examinations such as complete blood examination, X-rays, ultrasound, CT scan, or even MRI. In general, this disease can affect anyone. But there are some people who are more at risk of experiencing it, especially those who:
- More than 70 years old.
- Traveling or living in a place where this infection is common.
- Consuming liquor and or not getting enough nutrition.
- Taking drugs such as corticosteroids or undergoing chemotherapy.
- Experiencing certain diseases such as diabetes, cancer, or weakening the immune system. The study found that people with diabetes were 3.6 times more at risk of liver abscesses.
In general, liver abscesses are classified into two main types based on the cause, namely pyogenic and amoebic liver abscesses.
Piogenic Liver Abscess
A person is said to have a pyogenic liver abscess when experiencing a bacterial or fungal infection, which causes the formation of pus pockets in the liver. Apart from causing inflammation and swelling around the liver, abscesses can also cause pain and swelling in the stomach. Pain due to liver abscess is often felt in the right upper abdomen.
In addition, generally this pyogenic liver abscess is caused by various causes such as:
- Bile diseases that in addition to affecting the liver can also have an impact on the pancreas and gallbladder.
- Liver disease such as cirrhosis.
- Weakness in the body's immune system.
- Bacteria from the appendix that rupture and fester.
- Blood infection or septicemia.
- Inflammation of the large intestine.
- Injuries or accidents that result in injury to the liver such as stab wounds or bumps.
Be aware if you or a relative experiences symptoms that might indicate a pyogenic liver abscess. These symptoms can actually mimic symptoms of severe infection or inflammation of the gallbladder, such as: fever, chills, vomiting, dark urine, diarrhea, right or upper abdominal pain, white or gray stool, to drastic weight loss. If not treated immediately, liver abscesses can be fatal.
Some pyogenic liver abscess patients can recover with antibiotic treatment alone. However, most require drainage or drainage of pus by inserting a needle into the abscess to remove pus as well as a biopsy to determine overall liver health. Surgery may be needed if the abscess is large or more than one. In general, liver abscess management requires hospital treatment to prevent dehydration by administering fluids by infusion, improving general conditions, and administering injectable antibiotics according to the cause of liver abscess. Complete blood tests, blood cultures or pus fluid from the abscess sometimes need to be done to determine the causative germ and antibiotics.
Amoebic Liver Abscess
Amoebic liver abscesses are commonly caused by parasitic E. histolytica infections that occur in tropical or subtropical areas that are densely populated or with poor sanitation. This condition causes amoeba from feces to enter the mouth and intestinal mucosa, until it reaches the portal venous system that passes through the liver. Apart from liver abscesses, this infection can also cause amoebic dysentery and colitis.
It is worth watching out, liver abscess can only be detected for months, even years after someone travels to an endemic area of liver abscess. In addition, a person can experience not only one, but several abscesses in the liver.
Symptoms that accompany amoebic liver abscess include night sweats, nausea and vomiting, fever up and down, weight loss and anorexia, pain radiating from the right upper abdomen to the right shoulder, shortness of breath and cough due to diaphragmatic irritation, and jaundice . On physical examination, there is often a tenderness of the right upper abdomen or upper abdomen and enlarged liver. The good news, about 95% of amoebic liver abscess patients can recover with the treatment of the antimicrobial drug metronidazole.
Hydatid cyst or Echinococcosis
This cyst is an infectious disease caused by parasites or flatworms of the genus Echinocococcus. The main host of this parasite is the dog. There are two types of classification, namely cystic echinococcosis or hydatid cysts, and alveolar echinococcosis. This disease can infect humans if we consume food contaminated with parasitic eggs. Cysts caused by this disease can attack the liver, lungs and brain. Risk factors for this parasitic infection if often exposed to animals such as dogs that live in dirty environments, sheep, cattle, deer, pigs, and camels.
This disease at an early stage does not cause symptoms and can stay in the body until symptoms appear within a span of up to 10 years. Symptoms begin to appear when the size of the cyst is getting bigger. In the liver, symptoms that can occur include right upper abdominal pain, nausea, vomiting, swelling in the abdomen due to enlarged cysts, itching, skin and yellow eyes if the cysts block the bile ducts. Chronic coughing, coughing up blood, difficulty breathing, or pain when breathing are signs of hydatid cyst symptoms in the lungs.
To make the diagnosis, the doctor will perform a physical examination and supporting examinations such as complete blood, liver function, X-ray examination, ultrasound, and abdominal CT scan. Treatment of hydatid cysts is surgical removal of cysts and worms that cause disease, antibiotic or antiparasitic drugs such as bendimidazole to prevent recurrent infections, and prevention of complications such as shock or sepsis.
To prevent the above conditions, avoid alcohol consumption that can increase the risk of liver abscess, keep your environment clean and make it a habit to wash your hands. Eat a variety of healthy and fresh foods such as lean meat, vegetables, fruits, whole grains, nuts, and low-fat milk that are kept clean.
If left untreated, complications of liver abscess that can occur include secondary infections, sepsis, and rupture of pus bags due to untreated abscesses. If the pus bag ruptures, the germs can spread to other parts of the body such as the pleural cavity, the peritoneum, and the pericardium (the protective layer of the heart). These conditions are emergencies that need to be dealt with immediately with appropriate surgery and treatment so as not to cause death.
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