Liver abscesses are single and multiple. The infection usually metastasizes from the purulent focus present in the body. Characterized by hectic temperature, stunning chills, torrential sweats, tachycardia , dull, aching pain in the right hypochondrium, radiating to the right arm and scapula, local tenderness on palpation . X-ray examination - restriction of the mobility of the right dome of the diaphragm, its high location, an increase in the shadow of the liver.
Treatment of single abscesses consists in the opening, emptying and subsequent drainage. Mortality - 30-45%.
Amoebic liver abscess is a complication of amoebic dysentery. It is often asymptomatic, and only with a large abscess there are pains in the right hypochondrium.
Treatment with emetine (1.5 ml of 2% solution, 2 times a day for 4-8 days) is sometimes combined with surgical treatment.Go
Toxic liver degeneration (massive liver necrosis) is caused by exposure to liver poisons (industrial, vegetable), infections. Especially often occurs when an existing liver disease.
Predisposing factors to the development of toxic dystrophy in persons suffering from liver disease are: nerve shocks, excessive use of morphine, barbiturates, the addition of infectious diseases, ignoring the recommended diet.
Massive necrosis can be observed in the center of the lobules (with viral hepatitis) or on their periphery (with toxic liver damage). The clinical picture is characterized by unconsciousness, jaundice, a decrease in the size of the liver, progressive liver dysfunction, especially antitoxic, an increase in poisoning of all body systems, up to the development of hepatic coma (see).
The forecast is bad.
For treatment, see Hepatagia.
Tuberculosis of the liver may be different. Miliary disseminated liver tuberculosis is manifested by fever, chills, torrential sweats, enlarged liver and spleen , jaundice. Full recovery is possible with timely initiated anti-TB therapy in combination with steroid hormones. Tuberculous liver granulomatosis is observed in patients with pulmonary tuberculosis and other organs. Granuloma with a cheesy disintegration in the center, which can contribute to the development of tuberculous cholangitis , consists of lymphocytes. Tuberculomas and liver abscesses are very rare.
Syphilis The use of antibiotics in the treatment of syphilis dramatically reduced the number of cases of syphilitic liver damage. Liver damage can be observed in congenital syphilis and in the tertiary stage of acquired syphilis. Congenital syphilis is manifested as interstitial diffuse hepatitis. In case of tertiary syphilis, syphilitic gum develops in the liver. As a result of their scarring, the liver can become deformed, or the scars can compress the portal vein or bile ducts. Clinical symptoms are little pronounced. Laparoscopic examination can confirm the alleged diagnosis of syphilitic liver damage. Gumma may decrease in size under the influence of penicillin treatment.
Fig. 3. Lobular liver. Fig. 4. Gumma liver.
From other diseases of the liver - see Hepargia, Hepatitis, Hepatitis epidemic, Gallstone disease , Cirrhosis of the liver.