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    Abses Hepar

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    Simon Messi Siringoringo
    Abses hati atau abses hati adalah penumpukan cairan di parenkim hati yang disebabkan oleh infeksi bakteri, jamur, atau parasit. Ada tiga jenis utama abses hati berdasarkan etiologinya: abses piogenik yang paling sering polimikroba, abses ameba karena Entamoeba histolytica, dan abses jamur terutama karena Candida spp. Faktor risiko termasuk diabetes, sirosis hati, dan keadaan terkompromi. Diagnosis didukung den

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    Abses Hepar

    Uploaded by

    Simon Messi Siringoringo
    35 views12 pages
    Abses hati atau abses hati adalah penumpukan cairan di parenkim hati yang disebabkan oleh infeksi bakteri, jamur, atau parasit. Ada tiga jenis utama abses hati berdasarkan etiologinya: abses piogenik yang paling sering polimikroba, abses ameba karena Entamoeba histolytica, dan abses jamur terutama karena Candida spp. Faktor risiko termasuk diabetes, sirosis hati, dan keadaan terkompromi. Diagnosis didukung den

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    Abses hati atau abses hati adalah penumpukan cairan di parenkim hati yang disebabkan oleh infeksi bakteri, jamur, atau parasit. Ada tiga jenis utama abses hati berdasarkan etiologinya: abses piogenik yang paling sering polimikroba, abses ameba karena Entamoeba histolytica, dan abses jamur terutama karena Candida spp. Faktor risiko termasuk diabetes, sirosis hati, dan keadaan terkompromi. Diagnosis didukung den

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    35 views12 pages

    Abses Hepar

    Uploaded by

    Simon Messi Siringoringo
    Abses hati atau abses hati adalah penumpukan cairan di parenkim hati yang disebabkan oleh infeksi bakteri, jamur, atau parasit. Ada tiga jenis utama abses hati berdasarkan etiologinya: abses piogenik yang paling sering polimikroba, abses ameba karena Entamoeba histolytica, dan abses jamur terutama karena Candida spp. Faktor risiko termasuk diabetes, sirosis hati, dan keadaan terkompromi. Diagnosis didukung den

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 12

    Abses Hepar

    Erina Angelia
    Perceptor : dr.Lukas.,Sp.PD
    Definisi
    • Abses hati adalah penumpukan cairan di parenkim hati yang
    dihasilkan dari infeksi bakteri, jamur, atau parasit. Infeksi dapat
    menyebar ke hati melalui empedu, vena hepatika, atau vena porta,
    dengan perluasan infeksi yang berdekatan, atau sebagai akibat
    trauma.

    https://bestpractice.bmj.com/topics/en-us/640
    Etiologi
    •Gram-positive cocci: Streptococcus species (especially S. intermedius group), enterococci, and
    Staphylococcus aureus.
    •Anaerobes: Bacteroides species, Fusobacterium sp, Actinomyces sp, Clostridium sp, etc.
    •Enterobacteriaceae (E. coli, Klebsiella spp., etc) and other Gram-negative bacilli.
    •Yersinia enterocolitica: rare cause of liver abscess; if identified, consider underlying
    hemochromatosis.
    •Candida species

    •Entamoeba histolytica: amebic liver abscesses may complicate up to 10% of the cases of ame
    colitis.
    •Echinococcus granulosus: most common cause of hydatid cysts

    https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540259/all/Hepatic_Abscess
    Klasifikasi
    The three major forms of liver abscess, classified by etiology, are as
    follows:
    • Pyogenic abscess, which is most often polymicrobial, accounts for
    80% of hepatic abscess cases in the United States
    • Amebic abscess due to Entamoeba histolytica accounts for 10% of
    cases [2]
    • Fungal abscess, most often due to Candida species, accounts for
    fewer than 10% of cases

    https://emedicine.medscape.com/article/188802-overview
    Faktor Risiko
    • Diabetes
    • Liver cirrhosis
    • Immunocompromised state
    • Male sex
    • Advanced age
    • Proton-pump inhibitor use
    Diagnosis Banding

    •Acute Gastritis

    •Bacterial Pneumonia

    •Biliary Disease

    •Cholecystitis

    •Hepatocellular Carcinoma

    •Hydatid Cysts

    •Parapneumonic Pleural Effusions and Empyema Thoracis

    https://emedicine.medscape.com/article/188802-differential
    Diagnosis
    Pemeriksaan Fisik
    • Fever and tender hepatomegaly
    • Peningkatan suara nafas paru di bagian kanan dengan atelektasis
    maupun efusi dari pemeriksaan fisik dan radiologi
    • A pleural or hepatic friction rub can be associated with diaphragmatic
    irritation or Glisson capsule inflammation.
    • Jaundice may be present in as many as 25% of cases and usually is
    associated with biliary tract disease or the presence of multiple
    abscesses.
    Diagnosis
    • Labs:
    • For pyogenic liver abscess(es), positive blood cultures seen in up to 50%; alkaline phosphatase and WBC counts
    frequently elevated.
    • Hyperbilirubinemia with or without jaundice occurs in < 50% of patients.
    • Imaging:
    • Plain abdominal radiography: dx may be suggested on plain films (e.g., gas within the abscess)
    • Preferred: CT, US and MRI are the imaging modalities of choice in suspected liver abscess or FUO.
    • CT or US-guided percutaneous drainage or surgical drainage should be considered in all cases of hepatic abscess for
    diagnostic confirmation and culture.
    • Multiple, small abscesses may not be amendable to aspiration.
    • Serology:
    • Positive amebic or echinococcal serology helps differentiate parasitic liver abscess from pyogenic, especially in
    nonendemic areas. Serology cannot distinguish between active and prior infection.
    • Uncomplicated, small abscesses due to Entamoeba histolytica in endemic areas may not require aspiration; consider
    empirical rx.
    Terapi
    Komplikasi

    • Sepsis
    • Empyema resulting from contiguous spread or intrapleural
    rupture of abscess
    • Rupture of abscess with resulting peritonitis
    • Endophthalmitis when an abscess is associated with K
    pneumoniae bacteremia

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