Pyogenic_Hepatic_Abscesses

Pyogenic_Hepatic_Abscesses - Pyogenic Hepatic Abscesses Vic...

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Pyogenic Hepatic Abscesses Vic V. Vernenkar,D.O. St. Barnabas Hospital Bronx, N.Y.
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Introduction Described since age of Hippocrates In 1883 Koch described the amoeba as a cause of liver abscess. In 1938 Debakey published largest series in the lierature. Over last 2 decades,percutaneous drainage has becaome a therapeutic option.
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Frequency Uncommon, prevalence in autopsy series 0.29-1.47%. Incidence in the US is 8-15 per 100,000. Male to female ratio is 2:1 in recent studies. 4 th -6 th decades of life.
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Etiology Biliary disease accounts for 21-30%, with extrahepatic obstruction leading to ascending cholangitis and abscess. Also CBD stones, benign and malignant tumors, biliary enteric anastamoses.
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Etiology Infection via portal system Infectious process originates in abdomen, reaches liver by embolization of portal system. Appendicitis, diverticulitis, IBD, proctitis
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Etiology Hematogenous. Via hepatic artery. From systemic septicemia. No cause in 50% of cases, but increased in diabetics and metastatic cancer.
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Pathophysiology Access to liver by direct extension from nearby organs. Through portal vein and hepatic artery.
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Pyogenic_Hepatic_Abscesses - Pyogenic Hepatic Abscesses Vic...

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