Diagnóstico diferencial y abordaje terapéutico del absceso hepático amebiano y piógeno en adultos

Abstract

Introduction. Liver abscess is defined as solitary or multiple collections of purulent material encapsulated in the liver parenchyma and is an important cause of morbidity and mortality when the clinical approach and therapeutic approach is not appropriate. Most often two origins are distinguished, an amoebic liver abscess which is the most important complication of intestinal amebiasis by fecal – oral transmission or through the portal circulation; and a pyogenic liver abscess that is currently more common, caused by bacterial multiplication and is usually the result of underlying biliary pathologies. Objective: Differentiate clinically and by imaging amoebic liver abscess and pyogenic liver abscess that allows an adequate therapeutic approach and avoid complications in the patient. Methodology: Descriptive study based on the review of high-impact scientific articles from different databases such as Pubmed, Elsevier, Scielo, Scopus, from the last 5 years. Conclusión: Entamoeba Histolytica remains the main cause of amoebic abscess and pyogenic abscesses there is an evident increase in recent years of Klebsiella Pneumoniae by 54%, followed by Escherichia Coli 29% and polymicrobial cause 16%. Although intestinal amebiasis is very common in the environment, the fact that it causes extraintestinal invasion causing a liver abscess is only 2–5%, so recently studies indicate that 80% of liver abscesses are of pyogenic origin due to the increase in biliary pathologies, surgical procedures where the bile duct is manipulated, aging and liver transplants.