Cardiac output, CVP, pulmonary capillary wedge pressure, ABG, O 2
saturation, urine output, V/S are used to evaluate the patient's hemodynamic
status and intravascular fluid volume. Liver functions tests and coagulation profiel. I & O including drainage from T tube.LIVER ABSCESSES
Two categories of liver abscess have been identified: amebic and pyogenic.1. Amebic liver abscesses are most commonly caused by Entamoeba
histolytica. Most amebic liver abscesses occur in the developing countries of
the tropics and subtropics because of poor sanitation and hygiene.2. Pyogenic liver abscesses are much less common.Pathophysiology
Whenever an infection develops anywhere along the biliary or GI tract, infecting
organisms may reach the liver through the biliary system, portal venous system, or
hepatic arterial or lymphatic system. Most bacteria are destroyed promptly, but occasionally some gain a foothold. The bacterial toxins destroy the neighboring liver cells, and the resulting necrotic
tissue serves as a protective wall for the organisms. Meanwhile, leukocytes migrate into the infected area. The result is an abscess cavity full of a liquid containing living and dead
leukocytes, liquefied liver cells, and bacteria. Pyogenic abscesses of this type may be either single or multiple and small. Examples of causes of pyogenic liver abscess include cholangitis and abdominal
trauma.Clinical Manifestations
The clinical picture is one of sepsis with few or no localizing signs. Fever with
chills and diaphoresis, malaise, anorexia, nausea, vomiting, and weight loss may
occur.