Arya R, Kumar R, Priyadarshi RN, Narayan R, Anand U. Vascular complications of liver abscess: A literature review. World J Meta-Anal 2024; 12(3): 94519 [DOI: 10.13105/wjma.v12.i3.94519]
Corresponding Author of This Article
Ramesh Kumar, MBBS, MD, Additional Professor, Department of Gastroenterology, All India Institute of Medical Sciences, Phulwari Sharif, Patna 801507, Bihar, India. docrameshkr@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Rahul Arya, Ramesh Kumar, Department of Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
Rajeev N Priyadarshi, Ruchika Narayan, Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna 801507, Bihar, India
Utpal Anand, Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna 801507, India
Author contributions: Arya R, Kumar R, and Priyadarshi RN contributed to the concept and design of the manuscript, data collection, and wrote manuscript; Narayan R and Anand U contributed to the data collection, critical input, and manuscript writing; All authors have made a significant contribution and approved the final manuscript.
Conflict-of-interest statement: All authors have no conflict-of-interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ramesh Kumar, MBBS, MD, Additional Professor, Department of Gastroenterology, All India Institute of Medical Sciences, Phulwari Sharif, Patna 801507, Bihar, India. docrameshkr@gmail.com
Received: March 19, 2024 Revised: August 23, 2024 Accepted: August 30, 2024 Published online: September 18, 2024 Processing time: 177 Days and 15.8 Hours
Abstract
Extensive vascular network and proximity to the gastrointestinal tract make the liver susceptible to abscess formation. While pyogenic liver abscesses account for the majority of liver abscesses in the Western world, amebic liver abscesses are more prevalent in tropical and developing nations. Most liver abscesses heal without complications. However, various vascular complications can occur in these patients, including compression of the inferior vena cava, thrombosis of the portal vein and/or hepatic veins, hepatic artery pseudoaneurysm, direct rupture into major vessels or the pericardium, and biliovascular fistula. These complications can present significant clinical challenges due to the potential for haemorrhage, ischemia, and systemic embolism, thereby increasing the risk of morbidity and mortality. Mechanical compression, flow stasis, inflammation, endothelial injury, and direct invasion are some of the proposed mechanisms that can cause vascular complications in the setting of a liver abscess. For the diagnosis, thorough assessment, and therapeutic planning of vascular complications, more sophisticated imaging techniques such as multidetector computed tomography angiography or magnetic resonance angiography may be necessary. Although most vascular complications resolve with abscess treatment alone, additional interventions may be required based on the nature, severity, and course of the complications. This article aims to provide a systematic update on the spectrum of vascular complications of liver abscesses, offering insights into their pathogenesis, diagnosis, and management strategies.
Core Tip: Liver abscess is a focal infection of hepatic parenchyma caused by various bacteria and the protozoa Entamoeba histolytica. It poses a considerable risk of vascular complications, including venous thrombosis, arterial pseudoaneurysms, thromboembolism, and biliary communication, as these complications can cause ischemia and hemorrhages, presenting significant challenges to clinicians. This review summarizes the existing literature on these lesser-known complications, providing insights into their magnitude, mechanistic pathogenesis, diagnosis, and management strategies.
