1. Pyogenic Liver Abscess of Biliary Origin: The Existing Problems and Their Strategies.
- Author
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Shi SH, Zhai ZL, and Zheng SS
- Subjects
- Asia epidemiology, Bacteriological Techniques, Bile Duct Neoplasms diagnosis, Bile Duct Neoplasms epidemiology, Bile Duct Neoplasms mortality, Biliary Tract Surgical Procedures adverse effects, Biliary Tract Surgical Procedures instrumentation, Biopsy, Cholangiocarcinoma diagnosis, Cholangiocarcinoma epidemiology, Cholangiocarcinoma mortality, Cholelithiasis diagnosis, Cholelithiasis epidemiology, Cholelithiasis mortality, Humans, Liver Abscess, Pyogenic diagnosis, Liver Abscess, Pyogenic epidemiology, Liver Abscess, Pyogenic microbiology, Predictive Value of Tests, Recurrence, Risk Factors, Stents adverse effects, Tomography, X-Ray Computed, Treatment Outcome, Bile Duct Neoplasms therapy, Cholangiocarcinoma therapy, Cholelithiasis therapy, Liver Abscess, Pyogenic therapy
- Abstract
Pyogenic liver abscess (PLA) of biliary origin in Southeast Asia mainly occurs in patients with intrahepatic bile duct stone (IBDS) and extrahepatic bile duct stone (EBDS), bilioenteric anastomosis, or biliary stent. IBDS, as an endemic to Southeast Asia, remains a frequent etiology of acute cholangitis and PLA. PLA related to IBDS is characterized by high incidences of PLA recurrence and death related to infection, and difficulties in diagnosis of concomitant cholangicarcinoma. PLA of biliary origin is more likely caused by Escherichia coli, more often presented as polymicrobial infections, and more associated with extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae isolates. In this review, the authors summarize the differences on the presumed causes, pathogens, multidrug resistance, treatment, and prognosis of PLA between biliary origin and cryptogenic origin, the latter serving as a first and foremost presumed etiology of PLA. The authors also discuss the existing problems on early diagnosis of concomitant cholangicarcinoma related to IBDS., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
- Published
- 2018
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