Liver is an important organ which carries out many functions including production of bile, creation of hormones, controlling of cholesterol and cleaning of toxins from medicines, alcohol, drugs etc. Liver abscess is a cyst in the liver which is filled with puss. These abscesses are formed from infection which may reach liver from nearby structures like bile duct, intestines and appendix. Liver abscesses are also developed as a result of trauma caused to liver or as a result of surgeries being carried out in the nearby organs. If liver abscess is detected in time it can be treated and cured by antibiotics. A surgical procedure used for draining the abscess. If left untreated the liver abscess can burst and result in life threatening bacterial infection.
Hernia Symptoms
Over the counter medicines and changing food habits have been found to be very effective in reducing the symptoms. Reducing weight, reducing smoking and avoiding consumption of alcohol have also been found to be very effective methods for reducing the symptoms of this type of diseases. Patients who are not benefitted by any of these methods will be required to live with the symptoms or undergo surgical procedure named laparoscopic fundoplication to find a permanent solution to the problem.
Laparoscopic procedure
In this procedure the surgeon inserts cannulas through small incisions in the belly. Through these cannulas the Laparoscopic Hernia Surgeon pushes a laparoscope and other special instruments needed for the surgical procedure. Laparoscope is an instrument with a miniature camera and a light source on one end. The videos of the Laparoscopic Surgery and the internal organs taken by this camera are transmitted and displayed in front of the surgeon. The surgeon views these videos and performs the surgery controlling the instruments by their controls available near him. In this surgery the surgeon strengthens the lower esophagus by attaching upper part of the stomach to it. This reduces the reflux of food and acidic liquids back to the esophagus and strengthen the lower esophageal sphincter. In the cased of hiatal hernia the protruding intestine and stomach portions are pushed back to its normal place. A synthetic mesh will be placed near the hole in the diaphragm so that the pushed back stomach will not come back again through this weaker portion.
Symptoms
- Chocking or difficulty in breathing combined with high fever.
- Changes in mental alertness and behavioral changes like lethargy and confusion.
- Yellowing of skin and white color of your eyes(like in jaundice)
- Upper abdominal pain and nausea without vomiting.
- Loss of weight and weakness that cannot be explained.
Treatment
Treatment for liver abscess is based on its location, number of abscess, size and cause of formation of the abscess etc. Medications can be given to reduce the symptoms and to kill the infections. Draining of the pus and surgical removal of the pus and the abscess will be attempted by the surgeons when other methods do not become fruitful.
Surgical care
Surgical drainage of the pus was in practice till around 1970, when percutaneous drainage using refined image-guided techniques was introduced. Open surgery for the removal of liver abscess is based on two approaches. A transperitoneal approach is used to drain the pus and explore the abdomen to identify previously undetected abscess. Posterior transpleural approach is used for high posterior lesions although this approach does not help in finding out the unidentified abscess. Both these procedures can be done in a minimally invasive laparoscopic approach also, but they are followed in select cases only. This approach helps the surgeon to explore the entire abdomen and reduces the patient morbidity. Study conducted on the liver abscess surgical procedures have revealed that the patients treated by surgical procedure have experienced lesser treatment failures and secondary procedures where as the morbidity was comparable in the two procedures.
Peculiarities of surgical procedures.
- Less loss of blood and less pain as the incisions required for this surgery are smaller.
- Very fast recovery and return to routine activities are possible as the wounds heal faster.
- Yellowing of skin and white color of your eyes(like in jaundice)
- This procedure cannot be done on patients who had earlier undergone a surgical procedure in the target area.