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December 1960

Pyogenic Abscess of the Liver

Author Affiliations

From the Departments of Surgery of Presbyterian-St. Luke's Hospital and the University of Illinois College of Medicine.

Arch Surg. 1960;81(6):934-941. doi:10.1001/archsurg.1960.01300060080016

Abscess of the liver, of pyogenic origin, is associated with a high mortality rate. Multiple abscesses have been fatal, in most instances. With the advent of chemotherapeutic agents and antibiotic drugs, there has been improvement in the mortality rate. Reports of recovery in patients having multiple abscesses have appeared in recent years.

Pyogenic abscess of the liver is the result of spread of septic thrombi or bacteria through the tributaries of the portal vein. Appendicitis, with thrombophlebitis of the ileocecal veins, has been considered a major source of liver abscess.1-3 Pyogenic abscess of the liver may, however, follow trauma to the liver, cholangitis of the bile radicles, lymphatic spread from neighboring infections, and hematogenous spread from distant foci of infection, such as furuncles, osteomyelitis, and bronchiectasis. Abscesses of the liver have been reported following suppurative pelvic disease,4 diverticulitis,5 infected thrombosed hemorrhoids,5 suppurative pancreatitis,6,7 and ulcerative

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