Liver abscesses of biliary origin.

Liver abscesses represent a rare complication of inflammatory and calculous disease of the biliary system and are enhanced by tardy or delayed removal of the primary cause. Being the result of liver necrosis and depending on its extension they appear in polymorphous pattern and have the tendency to spread through the diaphragm into the chest. The differential diagnosis is not easy: from common cholangitis to sporadic necrosis of liver malignancy, suppurated hydatid cyst and other diseases. The best prophylaxis and the highest recovery rate is achieved by taking up an active surgical approach at the first signs of severe infection, especially in cases of relapse and of prolonged septic evolution in spite of the use of antibiotics and/or the (first) operative procedure. The choice of surgical procedure depends on local findings. An exceptional diagnostic difficulty represent the cases of suppurated intraheptic lithiasis.