Intra-hepatic abcess of biliary origin. About 3 cases

Intra hepatic abcesses of biliary origin are the extension to the liver of suppurative cholangitis. They are mostly, multiple scattered abcesses, seldom is it a single large abcess. They are the most frequent of pyogenic liver abcesses. Their clinical study is uneasy because their signs remain drow in the cholangitis presentation explaining that they are discovered during surgery or even at necropsy. Treatment is medico-surgical but morbidity and mortality remains elevated, owing to delayed diagnosis because of lack of specific signs. About 3 [three] observations of intra hepatic abcesses of biliary origin, a review of the literature is made to specify their pathogenic, diagnostic, therapeutic and prognosis problems

Les abces intra-hepatiques d'origine biliare: a propos de 3 observations

The intrahepatic abscesses of biliary origin represent the extension of cholangitis to liver. They are the most frequent of pyogenic abscesses of liver. Our study carry 3 [Three] observations and aim to clear their pathogenics, diagnosis, therapeutics and prognosis problems. The abscesses were multiple scettes, rarely single and with great size. The symptoms were the same of cholangitis explaining their discovery at operation or at necropsy. Their treatment is medico-surgical their mortality is very high because the diagnosis is late by want of specific signs of abcesses. Our 3 cases are female sex aged respectively 23; 30 and 50 years and were admitted for cholangitis. The diagnosis of intrahepatic abscesses was called in preoperatory for 2 ceses by scanning, and operatory in one case by cholangiography. Two patients were operated with ablation of obstacle and biliary drainage by Kehr in one case, and internal drainage by sphincterotomy in the second case. The surgical act was accompanied with antibiotherapy who the unique treatment for the third case operated, before for choledocolithiasis. In conclusion, an early diagnosis by actual means and treatment of all lithiasis's bowl who give an obstacle of choledoc and cholangite