- Abdominal infection, such as appendicitis, diverticulitis, or a perforated intestine
- Infection in the blood
- Gallstones and/or Infection of the bile ducts(cholangitis)
- Recent endoscopy or surgery of the bile ducts
- Penetrating Injury to the liver
- Bacteria cause most liver abscesses, in some cases, it can be caused by parasites as well
- Pain in the upper abdomen or throughout the abdomen
- Right or left shoulder pain (referred pain)
- Fever, chills, rigors & night sweats
- Loss of appetite
- Nausea, vomiting
- Fatigue, Malaise or confusion (in severe cases)
- Yellow skin (jaundice) with pale-coloured stools, tea coloured urine
- Ultrasound (US) or Computed Tomography (CT) scan of the abdomen
- Blood tests- Blood culture for bacteria, Full blood count, Liver panel
Treatment usually consists of placing a small tube through the skin into the liver to drain the abscess under imaging guidance (CT or US) [Percutaneous drainage]. Occasionally, surgery may be necessary if the abscess is complex or the initial drainage or treatment fails.
You will also receive antibiotics for about 4 to 6 weeks. Sometimes, antibiotics alone can cure the infection if the abscess is small and there are no associated complications.
Life-threatening sepsis can develop. Sepsis is an illness in which the body has a severe inflammatory response to bacteria or other germs, this can be worse in patients with diabetes or those who are immunosuppressed.
Beside treatment of the infection, it is necessary to ensure that it is not cancer mimicking an infection and also find out the cause so as to prevent future recurrences.
Please consult your liver surgeon early if you have the above symptoms as early treatment is effective and can prevent it from becoming more serious.
Senior Consultant Hepatopancreatobiliary Surgeon
MBBS, MMed (Surgery), MSc, FAMS, FRCSEd
Prior to private practice, Dr Lee Ser Yee was a founding member and Senior Consultant at the Department of Hepatopancreatobiliary (HPB) and Transplant Surgery at Singapore General Hospital (SGH). He served as the Director of the Laparoscopic programme and the Director of the Surgical Skills Training Program and the SingHealth Surgical Skills Centre.
He started his medical training at the National University of Singapore in 1996 and completed his training in General Surgery, HPB surgery and Liver Transplantation at SGH and National Cancer Centre, Singapore.
He also completed dual USA-fellowships in Advanced Laparoscopic HPB surgery and Liver Transplantation under Professor Daniel Cherqui at the New York Presbyterian Hospital-Weill Cornell Medical Center and a Complex Surgical Oncology clinical fellowship at Memorial Sloan Kettering Cancer Center in New York.