What are the pathophysiology and etiology of liver abscesses associated with hepatic cysts?

Updated: Jun 12, 2018
  • Author: Robert E Glasgow, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

Hepatic abscesses can be amebic or bacterial in origin. Entamoeba histolytica is the causative agent in amebic abscesses. It is contracted by ingestion of food or water contaminated by the cyst stage of the parasite. Amebiasis generally only involves the intestine but can invade the mesenteric venules resulting in liver abscesses. Its only host is the human. Pyogenic abscesses can be a result of instrumentation but are most often caused by ascending cholangitis in the setting of biliary obstruction. Microorganisms isolated are most often bowel flora. Other routes of contamination include the portal vein and hepatic artery.

Patients with intra-abdominal infections may present with liver abscesses with extension of bacteria through the portal venous system. Hematogenous spread via the hepatic artery in patients with septicemia is rare.


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