Treatment of liver abscess

Written by Zhang Wei Wei
Integrative Medicine
Updated on September 16, 2024
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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.

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Written by Zhang Wei Wei
Integrative Medicine
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Should one abstain from certain foods if they have a liver abscess?

Dietary restrictions are necessary for liver abscesses, which are purulent liver diseases caused by various microorganisms such as bacteria, fungi, or amoebae. If not treated promptly, the mortality rate can reach 10% to 30%. What should one pay attention to in their diet? First, absolutely no alcohol consumption during the onset of the disease, as it increases the burden on the liver and delays the healing of the liver abscess. Second, spicy, stimulating, greasy, and fried foods must be avoided as they can aggravate the liver abscess. Third, pickled vegetables and certain foods considered "heaty" by traditional Chinese medicine should also be avoided, such as beef, lamb, dog meat, longan, and lychee. It is recommended to consume a light diet and eat vegetables and fruits that can clear heat and detoxify.

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Written by Zhang Wei Wei
Integrative Medicine
1min 55sec home-news-image

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.

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Written by Zhang Wei Wei
Integrative Medicine
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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.)

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Written by Zhang Wei Wei
Integrative Medicine
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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.

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Written by Zhang Wei Wei
Integrative Medicine
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Clinical manifestations of liver abscess

Clinical manifestations of liver abscess include irregular, purulent fever, especially noticeable in bacterial liver abscesses. The fever is irregular and typically high, preceded by chills, followed by persistent pain in the liver area, which worsens with deep breaths or movement. Depending on the location of the abscess, it can lead to corresponding respiratory and abdominal symptoms, often with a history of diarrhea. If the abscess ruptures, it can evolve into purulent peritonitis with pyothorax. Special signs include liver enlargement, and in the intercostal space corresponding to the abscess, there's localized edema and clear tenderness. Some patients may exhibit jaundice. If the abscess breaks into the chest cavity, lung abscesses can occur, or if it perforates into the abdominal cavity, peritonitis may develop.