- Vroeger bij "foi appendiculaire" - portaal abcederende hepatitis na appendicitis 2
- Huidige oorzak: galwegpathologie
Etiologie
1. Opstijgende infectie vanuit de galwegen 3-9
2. Hematogene verspreidingsroute 10
3. Directe uitbreiding van een intra-abdominale infectie zoals bij fistelvorming (bijvoorbeeld subfrenisch abces of maagulcus) en necrose van het leverparenchym 2,6,8,9,11
4. Cryptogeen: in circa 40% van de leverabcessen - onduidelijke ethiologie 1,12
Microbiologie:
- Galwegpathologie: gramnegatieve aerobe bacteriën en enterokokken vooral E. Coli 13
- Alleen operatieve drainage bij klinische verslechtering ondanks percutane drainage en antibitioca
Referenties
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