Liver Abscess | Surgery Department .pptx

liver abscess definition, classification, management medication dan surgery

1. Liver Abscess (PLA vs ALA) Henderi Saputra

2. Definition Hepatic abscess can be defined as an encapsulated collection of suppurative material within the liver parenchyma, which may be infected by bacterial, fungal, and/or parasitic micro-organisms. PLA = Pyogenic Liver Abscess ALA = Amoebic Liver Abscess

3. Incidence PLA 22:100.000, and it will rise because of aggressive management approach to hepatobiliary and pancreatic cancer os well as major improvements in diagnostic imaging ALA 500 million people are carriers, 50 million people have active disease, 50.000 to 100.000 die annually

4. Etiopathogenesis Amoebic Liver Abscess (ALA) Entamoeba histolytica Fecal -oral transmission occurs The cyst passes through the stomach into the intestine unscathed, and pancreatic enzymes start to digest the outer cyst wall. The trophozoite is then released into the intestine and multiplies there. Normally, no invasion occurs, and the patient develops amebic dysentery or becomes an asymptomatic carrier. In a small number of cases, the trophozoite invades through the intestinal mucosa, travels through the mesenteric lymphatics and veins, and begins to accumulate in the hepatic parenchyma, forming an abscess cavity.

5. Etiopathogenesis Pyogenic Liver Abscess (PLA) Invasion of microorganism

6. Clinical Presentation

7. Radiological Finding

8. Diagnosis PLA The clinical presentation of pyogenic liver abscess is usually subacute and nonspecific, leading to delays in presentation, diagnosis, and treatment. The classic triad of fever, jaundice, and right upper quadrant tenderness was maybe present HLA The definitive diagnosis of amebic liver abscess is by detection of E. histolytica trophozoites in the pus and by finding serum antibodies to the ameba.

9. The ALA treatment

10. The treatment of choice for PLA

11. Patients in whom percutaneous drainage is not appropriate include those with (1) multiple large abscesses; (2) a known intra-abdominal source that requires surgery; (3) an abscess of unknown etiology; (4) ascites; and (5) abscesses that would require transpleural drainage

12. Advantages of the transperitoneal approach include the ability to ( 1) treat the inciting pathology in the remainder of the abdomen/pelvis; (2) gain access and exposure of the entire liver for evaluation and treatment; and (3) access the biliary tree for cholangiography and bile duct exploration

13. Complication

14. TERIMA KASIH

15. Tugas Sistem pertahanan Usus Jalur Limfatik Colon Jalur vena colon

16. Gastrointestinal Immune system

17. Drainage Lymphatic Colon

18. Drainage Vena Colon