Non‐operative management of pyogenic liver abscess

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Abstract
Pyogenic hepatic abscess is a rare but potentially lethal condition, with a reported incidence of 20 per 100000 hospital admissions in a western population [ 1 x 1 Huang, C.‐.J., Pitt, H.A., and Lipsett, P.A. Pyogenic hepatic abscess. Ann Surg. 1996; 223: 600–609 Crossref | PubMed | Scopus (300) | Google Scholar See all References 1 ]. Historically the commonest cause has been acute appendicitis [ 2 x 2 Oschner, A., DeBakey, M., and Murray, S. Pyogenic abscess of the liver. Am J Surg. 1938; 40: 292–353 Abstract | Full Text PDF | Scopus (212) | Google Scholar See all References 2 ], but in the era of modern surgery and antibiotics, this cause has declined drastically in importance. Other causes of ascending portal pyaemia have become increasingly important; in recent series the biliary tract has been the commonest source of sepsis, due to gallstones, bile duct strictures, endoscopic interventions and operation [ 1 x 1 Huang, C.‐.J., Pitt, H.A., and Lipsett, P.A. Pyogenic hepatic abscess. Ann Surg. 1996; 223: 600–609 Crossref | PubMed | Scopus (300) | Google Scholar See all References , 3 x 3 Giorgio, A., Tarantino, L., and Mariniello, N. Pyogenic liver abscess: 13 years of experience in percutaneous needle aspiration with US guidance. Radiology. 1995; 195: 122–124 Crossref | PubMed | Scopus (103) | Google Scholar See all References ]. The increasing medical use of immunosuppression also provides a fertile environment for the development of this condition [ 4 x 4 Branum, G.D., Tyson, G.S., Branum, M.A., and Meyers, W.C. Hepatic abscess. Ann Surg. 1990; 212: 655–662 Crossref | PubMed | Scopus (200) | Google Scholar See all References 4 ].

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