Heptaobiliary infections

Although cholangitis is the most prevalent hepatobiliary infectious process , liver abscess represents the most serious and conspicuous hepatobiliary i nfection. Amebic liver abscess typically occurs in individuals from endemic areas or those traveling to endemic areas. It is associated with an excell ent prognosis when managed expediently with antiamebic antibiotics. Recent reports emphasize a possible association between amebic liver abscess and H IV infection. Drainage or surgery for amebic liver abscess is rarely necess ary. In contrast, pyogenic liver abscess is associated with significant mor bidity and mortality, although the prognosis of patients with this hepatobi liary infection has improved in recent years. Pyogenic liver abscess occurs most often in patients without identifiable predisposing factors, but when identified, they are most often biliary tract-related. Management of pyoge nic liver abscess has historically been surgical, but in recent years, ther e has been a dramatic shift toward noninvasive management, particularly inv olving strategies based on percutaneous drainage techniques. Curr Opin Gast roenterol 2000, 16:251-254 (C) 2000 Lippincott Williams & Wilkins, Inc.