Division of Gastroenterology, Hepatology Program, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, USA.
Division of Gastroenterology, Hepatology Program, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, USA.
Gastroenterol Clin North Am. 2020 Jun;49(2):361-377. doi: 10.1016/j.gtc.2020.01.013.
Pyogenic liver abscesses are classified by the bacteria that have caused the abscess because this guides treatment and can point to the underlying cause. The most common cause is biliary disease. The diagnosis is made by imaging. Treatment is a combination of antibiotics and percutaneous drainage. Amebic liver abscess is caused by extraintestinal spread of Entamoeba histolytica. E histolytica is spread by fecal-oral transmission and typically colonizes the gastrointestinal tract. It is diagnosed based on imaging and the mainstay of treatment is metronidazole. Only about 15% of cases require percutaneous drainage. The prognosis is good, with almost universal recovery.
化脓性肝脓肿是根据引起脓肿的细菌进行分类的，因为这有助于指导治疗，并能指出潜在的病因。最常见的病因是胆道疾病。诊断是通过影像学检查做出的。治疗方法是抗生素和经皮引流的联合应用。阿米巴性肝脓肿是由溶组织内阿米巴经肠外播散引起的。溶组织内阿米巴通过粪-口途径传播，通常定植于胃肠道。它的诊断基于影像学，治疗的主要方法是甲硝唑。只有约 15%的病例需要经皮引流。预后良好，几乎普遍恢复。
