Subscribe
25
Zhang Wei Wei
Integrative Medicine
About me
Zhang Weiwei, associate chief physician, graduated from Hunan University of Traditional Chinese Medicine, engaged in the clinical work of integrated Chinese and Western internal medicine for more than 10 years, and studied in the oncology department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine. He has rich clinical experience.
Proficient in diseases
Specializes in the diagnosis and treatment of advanced tumors, infertility, menstrual disorders, pelvic inflammatory disease, breast diseases, and cardiovascular diseases using a combination of traditional Chinese and Western medicine.
Voices
Why is there a low fever with a liver abscess?
Why do patients with liver abscesses continuously have a low fever? This is because a liver abscess is a purulent liver condition caused by various microorganisms such as bacteria, fungi, or amoebas, indicating severe inflammation due to the presence of pus in the liver, resulting in a fever. But why is it a low fever? The reason may be attributed to the fact that it is inherently a bacterial infection. Treatment requires prolonged use of high-dose, full-course antibiotics. During this process, some bacteria might not be completely eradicated, or some residual bacteria continue to linger in the liver, thereby easily causing fever. Fever is a manifestation of the body's self-protection, so there is no need for excessive worry or anxiety. With proper full-course treatment, the disease can be cured. (Please use medication under the guidance of a doctor.)
Will ferritin be high in hepatic abscess?
Will ferritin levels rise in cases of liver abscess? First, we need to understand the significance of ferritin testing. I can also tell you that ferritin does not necessarily increase during a liver abscess. The main form of iron in the body is present as serum ferritin. Clinically, its relationship with the aforementioned diseases is something we can discuss. The first one is related to iron-deficiency anemia. Generally, early stages of iron deficiency do not directly cause significant anemia, but they will lead to a reduction in iron stores. There are many methods for determining serum iron content in clinical laboratories, but none are as sensitive and reliable as serum ferritin. The second point is its relationship with tumors. Ferritin acts as a soluble tissue protein that stores iron in the body. It consists of a protein shell and an iron core, with the iron core having a strong capacity to bind and store iron, maintaining the supply of iron and the relative stability of hemoglobin. The liver is the site of synthesis of serum ferritin and also the organ that clears it. Normally, only a small amount is found in the serum, so during acute or chronic liver damage, or liver cancer, a noticeable increase occurs. Therefore, when liver abscesses affect liver function or cause destruction of liver cells, it can also lead to increased ferritin levels. However, in the early stages of a liver abscess, if treatment is proactive, ferritin levels might not increase.
Principles of medical treatment for liver abscess
The principle is early diagnosis and early treatment, including the management of the primary disease, and then avoiding the occurrence of complications. Non-surgical treatment requires the use of effective and sufficient amounts of antibacterial drugs, proactive supportive care, and enhancement of the body's resistance. For a single larger abscess, it can be punctured and drained under ultrasound guidance, or continuously flushed and drained through percutaneous catheter placement, and treated with injection of antibiotics. However, the antibiotic treatment for liver abscess requires a sufficient amount and full course of symptomatic supportive care to suppress the spread of inflammation and facilitate rapid absorption of inflammation. At the same time, we can adopt some traditional Chinese medicine methods and treatment approaches to reduce swelling and drain pus, which synergistically enhance the treatment effect.
What is good to eat for a liver abscess?
You should eat a diet that is easy to digest, high in vitamins, low in fat, and high in calories. Avoid fatty, greasy, spicy, and stimulating foods. So, what types of food can we choose? We can choose foods like millet and pig stomach, including beans, because beans are high in protein, calcium, iron, and vitamin B. You can also eat seafood such as hairtail and yellow croaker, which can enhance immunity, repair damaged tissue cells, and strengthen the body's resistance to prevent viral infections. Additionally, you can eat fruits that clear heat and detoxify, relieve irritability, and quench thirst, such as dragon fruit, pears, apples, etc. You can also consume foods that are rich in potassium.
Does liver abscess have a connection with drinking alcohol?
Patients with liver abscesses are prohibited from drinking alcohol, because the main component of alcoholic beverages is ethanol, which needs to be metabolized by the liver and directly damages it. Excessive drinking can exacerbate the burden on the liver, worsening the condition. Therefore, patients with liver abscesses must absolutely avoid alcohol. If a patient insists on drinking, they should only do so in moderation three months after the abscess has healed. However, it is generally advised not to drink at all. It is beneficial for the liver if patients consume fresh vegetables and fruits and maintain a light diet, avoiding greasy and rich foods. This diet can also prevent the adhesion and aggregation of platelets, reduce the decline in white blood cells, and promote blood circulation and dispel stasis.
Can a liver abscess cause ascites?
Can liver abscess cause ascites? Some liver abscesses can cause ascites. Firstly, it must be understood why ascites occur. It is because the patient has poor resistance, internal infections, and is prone to worsened infections. A liver abscess involves significant energy consumption due to prolonged fever and intermittent fevers, which can reduce the liver’s capacity to synthesize albumin, leading to a decrease in colloid osmotic pressure within the blood vessels. This is accompanied by the formation of fluid accumulation in the abdominal cavity. Therefore, when a patient with a liver abscess develops ascites, there is no need to be overly anxious or nervous. Treatment can involve vigorous anti-infection measures, supplementation with albumin, and other supportive treatments to improve the symptoms and alleviate the patient's ascites, facilitating a quicker recovery.
What should I do if a liver abscess ruptures?
Firstly, we must keep our emotions stable, avoid being nervous, avoid anxiety, and avoid shouting loudly, as these can increase the likelihood of bleeding. Do not excessively increase the pressure in the abdominal cavity. So, what treatment methods do we have? There are two types of treatments: surgical and non-surgical. If the patient has a mild liver rupture and stable vital signs without persistent active bleeding, treatment can be administered through blood transfusion, fluid infusion, hemostasis, antibacterial drugs, and hepatoprotective drugs. However, it is crucial to closely monitor the patient's vital signs and regularly review the imaging studies of the condition. We must diligently observe any changes in the patient's condition. If evidence of active bleeding occurs during conservative treatment, then surgical intervention must be immediately performed.
Treatment of liver abscess
The treatment of liver abscesses is divided into medical and surgical treatment. Medical treatment mainly involves antibiotic therapy. For bacterial liver abscesses, especially during the acute phase when the inflammation is localized and an abscess has not yet formed, or there are multiple small abscesses, aggressive conservative medical treatment should be given. This involves the use of high doses of antibiotics and general supportive therapy to control the absorption of inflammation. The second method is antibiotics combined with percutaneous puncture drainage. For a single, larger liver abscess, aspiration of pus can be performed under ultrasound guidance. After aspirating as much pus as possible, antibiotics can be injected into the abscess cavity, followed by repeated punctures over several days, or a tube can be placed to drain the pus. When the abscess shrinks and the fluid output decreases, the tube can be removed. The third method is antibiotics combined with surgical drainage. For larger liver abscesses that have a potential to rupture and cause complications such as acute peritonitis and pyothorax, surgical incision and drainage should be performed urgently, alongside the use of systemic antibiotics. The fourth approach is antibiotics combined with surgical resection. For chronic liver abscesses, or those whose abscess walls do not collapse after drainage, leaving a dead space, or with sinus tracts that continually discharge pus without healing and where liver lobe destruction is severe with loss of normal functions, hepatic lobectomy can be performed.
Reasons why liver abscesses do not liquefy
The reasons for the non-liquefaction of liver abscesses, in my opinion, are several. The first is that the abscess is very large, and the second is the inappropriate use of antibiotics. So, what can we do to solve this problem? Firstly, liquefaction of a liver abscess takes time, and it is difficult for a large abscess or a single large abscess to be absorbed on its own. Therefore, it requires combining with percutaneous drainage. Often, even if the abscess has not fully liquefied, fine needle aspiration can still be performed to extract the pus for culture, and then identify the sensitive antibiotics. After administering a sufficient amount and course of the sensitive antibiotics, the liquefaction of the liver abscess can be accelerated and the pus can be expelled sooner.
Liver abscesses are treated in the Department of Hepatology.
This is likely a common and frustrating issue for many patients who visit this hospital on a daily basis. As the name suggests, liver abscess is related to the department of hepatobiliary sciences. It can also be looked into by other departments linked to the liver, such as hepatology, infectious disease department, and even the department of traditional Chinese medicine. No matter which department you visit, you can initially undergo some routine blood tests, abdominal ultrasound, CT scans, etc., to determine the size and scope of the liver abscess, check whether it has ruptured or caused any bleeding. Subsequently, based on the doctors' initial diagnosis, you can be referred to the relevant department. If surgery is needed, the patient should visit the department of hepatobiliary surgery. If surgery is not necessary, the departments of infectious diseases, hepatology, or traditional Chinese medicine are all viable options.