LIVER ABSCESS IN CHILDREN
Dewy Ratyh Ibrahim, Siti Aizah Lawang
Department of Child Health, Faculty of medicine, Hasanuddin University
Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
ibrahimdewyratyh@gmail.com
Abstract
Background: Liver abscess is an important but relatively rare disease in children. The highest prevalence occurs in tropical and developing countries with poor sanitation, low socioeconomic status and poor nutritional status. The most common liver abscesses are pyogenic caused by Staphylococcus Aureus, and then amoebic caused by the protozoan Entamoeba Histolitica.
Case Description: A male patient aged 12 years and 11 months came with chief complaint of lump in the right upper abdomen accompanied with pain. The lump was noticed since 2 months prior to hospitalization. There was history of frequent fever, vomiting and significant weight loss over the last 2 months. On physical examination, he was under nourished. There was hepatomegaly, positive Ludwig’s sign and palpable mass in the right upper quadrant. Abdominal MSCT without contrast showed hepatomegaly with hypodense lesions, suspected of right lobe liver abscess and right lumbar mesenteric abscess. The patient received antibiotic and underwent to surgery for abscess drainage. Surgery revealed hepatic abscess involving 5 right hepatic lobe segments. The pus culture did not reveal any bacterial growth.
Conclusion: Liver abscess is a form of infection in the liver caused by microorganism originating from the gastrointestinal system which is characterized by the formation of liver pus as a process of invasion and multiplication that enters directly from injury to blood vessels or the biliary duct system. A shift to the left leukocytosis, anemia, increased CRP levels, increased liver function and hyperbilirubinemia are laboratory features that are often found in liver abscesses. Examination of pus culture from abscess aspiration can establish the bacteria causing liver abscess. Conventional management is surgical open drainage and broad-spectrum antibiotics.
Keywords: liver abscess, pyogenic, amoebic.