EUS-Guided Drainage of Liver Abscesses: Ultra Uncertain or Sound Practice?

Excerpt

Liver abscesses, which are collections of infected necrotic tissue within the hepatic parenchyma, as the most common intra-abdominal abscess have a reported incidence of 8–20 cases/100,000 hospitalized patients/year in the USA [1]. Abscesses, which are frequently attributed to polymicrobial infections (e.g., Klebsiella species) and less frequently by Entamoeba, are typically associated with biliary tree infection due to benign or malignant obstruction, and rarely as an extension of intra-abdominal infections (e.g., appendicitis) or via hematogenous spread due to septicemia. Recent diagnostic and therapeutic advances that have facilitated early diagnosis, that have supported the extensive use of specific antibiotics, that have furthered the development of radiologic aspiration or drainage techniques, and have driven the evolution of modern liver surgery, have substantially modified the clinical course of liver abscesses. In a recent meta-analysis [2], percutaneous drainage (PCD) of liver abscesses was reported to be superior to percutaneous aspiration alone. …