Quick Summary

liver abscess:

• is a collection of thick liquid or pus
• is caused by an infection
• people may have one or more abscesses
• symptoms include pain and fever
• is usually diagnosed with a scan
• needs to be treated in hospital with antibiotics
• sometimes needs to be drained

Find out more about liver abscesses on this page.

What is a liver abscess?

An abscess can form in many parts of the body after an infection. This information is about abscesses in the liver or bile ducts.

In the UK liver abscesses are usually caused by a bacterial infection. The infection creates a lump filled with pus, blood and dead cells.

Things that can be confused with a liver abscess

Other things can also cause lumps in the liver. These need different treatments, so it is important to find out what is the nature of the lump.

• A liver abscess is not a type of cancer or tumour

Find out more about benign liver tumours.

Find out more about liver cancer.

• A liver abscess is not a type of liver cyst

Find out more about liver cysts.

Hydatid cysts are a type of liver cyst that can sometimes be confused for an abscess. Hydatid cysts are very rare in the UK. They are caused by a parasite. Cases most often occur in areas with a lot of sheep farms. The treatment for hydatid cysts differs from that for an abscess.

Find out more about hydatid cysts.

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What causes liver abscesses?

Bacterial liver abscess

This is the most common type of liver abscess. The infection can get to the liver in a few different ways:

• Bile duct infections:
  • If something blocks the bile ducts, like gallstones, this can lead to an infection. The bacteria can then sometimes move from the bile ducts or gallbladder into the liver.
• Infections in the gut:
  • Conditions such as appendicitis, diverticulitis, or a perforated bowel can release bacteria into the portal vein in the liver.
• Widespread Sepsis:
  • If there is a bacterial infection in the bloodstream (sepsis) it can travel to the liver.
• Injury or surgery to the liver:
  • If the liver is injured this can allow bacteria to get in. This could be an injury from an accident. It is also a risk of surgery or endoscopic procedures.
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Parasitic (amoebic) liver abscess

Amoebic liver abscesses are caused by a parasite. The parasite usually first infects the intestines. This is called amoebic colitis. It can then sometimes spread to the liver.

These abscesses are more common in tropical and subtropical regions. In the UK they are mostly seen in people who have spent time in an area where they are common.

Fungal liver abscess

Fungal abscesses are less common. They usually affect people who have a weakened immune system. For example, people who are immunocompromised because of a long-term illness.

People with this condition often have multiple small abscesses.

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What are the symptoms of a liver abscess?

The symptoms of a liver abscess can include:

• fever (high temperature)
• loss of appetite
• losing weight without trying
• pain in the upper right side of the abdomen (tummy)

If you or your child has any of these symptoms, see your GP or call NHS 111 as soon as possible.

Red flag symptoms

Go to A and E if you or your child:

• have any of the symptoms above, and
• A fever (high temperature) and tummy (abdominal) pain

Find out more about liver disease symptoms

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Tests and diagnosis of a liver abscess

Liver abscesses are usually diagnosed with imaging tests.

This could be an:

• Ultrasound scan
• MRI
• CT scan

Doctors might also suggest a procedure to take out some of the liquid in the abscess.

This will help to confirm that the lump is an abscess. The liquid will be tested in a lab to find out what has caused it. This will help doctors choose the best treatment.

Find out more about tests for liver disease.

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Treatment for a liver abscess

Liver abscesses are usually treated with antibiotics. Sometimes they will also be drained.

Antibiotics

Most liver abscesses need antibiotic treatment. This will kill the bacteria that is causing them.

People having antibiotic treatment for a liver abscess must stay in hospital to start with. This is so that antibiotics can be given into the blood through an injection or in a drip. This is called intravenous antibiotics.

If they start to feel better, some people can change to antibiotic tablets or medicines taken at home. This depends on the type of bacteria causing the abscess.

Treatment for a liver abscess usually takes 6 weeks. But can sometimes be longer. Doctors will do more scans to check if the treatment is working. This will usually be ultrasound or CT scans.

Draining

If antibiotics do not work on their own, it might be necessary to drain the fluid out of the abscess.

This is usually done by putting a small tube called a catheter into the abscess. Doctors use scans to guide the tube into the right place. The fluid can then drain out.

In some rare cases doctors use a surgical procedure to drain the cyst.

Which treatment is best depends on a lot of different things.

It is important to talk to your medical team for personal advice. Before deciding if you want to have a treatment or not, it can help to ask:

• What are the benefits of this treatment?
• What are the risks?
• Are there any alternatives?
• What would happen if we did nothing?

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