What is a liver abscess puncture? What are the indications, contraindications, complications, postoperative care, and postoperative diet of liver abscess puncture?

What is a liver abscess puncture? What are the indications, contraindications, complications, postoperative care, and postoperative diet of liver abscess puncture?

What is a liver abscess puncture? What are the indications, contraindications, complications, postoperative care, and postoperative diet of liver abscess puncture?

Liver abscess is a hepatic suppurative lesion caused by a variety of microorganisms such as bacteria or amoeba, and is often guided by B-ultrasound or CT-guided percutaneous transhepatic abscess lesions and drained into the drainage tube.

Anesthesia and preoperative preparation

1. Anesthesia
Local infiltration anesthesia.
2. Preoperative preparation

• Check blood routine, platelet, and prothrombin time.
• Fasting for 8 to 12 hours before surgery, if the abdominal flatulence is obvious, you can take the anti-swelling medicine or clean the enema beforehand.

Indication

1. Clinically suspected liver abscess, and ultrasound showed intrahepatic hypoechoic or mixed echo lesions, need to be clearly diagnosed.
2. Larger single liver abscess, ultrasound guided by thick needle aspiration or catheter drainage.
3. For multiple liver abscesses, you can puncture 2 to 3 lesions at a time, or you can use multiple drainage tubes or tube drainage in a batch.

Contraindication

1. Those who have a serious bleeding tendency.
2. The puncture can not avoid large blood vessels or important organs.
3. In the early stage of abscess, the abscess is not completely liquefied, and the actual inflammation is the main.

Surgical methods
1.Suction washing method
If the abscess is not large, it can be cleaned once and then infused with antibiotics. Keep an appropriate amount of antibiotics and then remove the needle.

2. Tube drainage method
Ultrasound-guided drainage can be performed when the abscess is large or has not been cured by repeated aspiration. According to the size of the abscess, the consistency of the pus, the length of the drainage time, the trocar puncture method or the Seldinger method is selected.

Precautions

1. Select the best puncture point and puncture path before puncture.
2. Multiple abscesses or abscesses consist of multiple lumens, which require separate puncture and adequate drainage for each abscess.
3. During the indwelling catheter, flush the abscess every day to keep the catheter ventilated.
4. The catheter retention time should not be too long, generally not more than half a month.

Complication
Liver hemorrhage, biliary tract injury, abdominal infection (peritonitis), chest infection (eupoid)

Postoperative care

1. After bandage with abdominal bandage for 24 hours, the patient should be lying for 12 to 24 hours, and continue to observe blood pressure and pulse changes after surgery.
2. Continue anti-infective and other systemic treatment.
3. For the tube drainage, flush the abscess daily with antibiotics and saline.

Postoperative diet

1. Diet should pay attention to light, nutritious and easy to digest.
2. Eat more fresh fruits and vegetables to ensure the intake of vitamins.
3. Give liquid or semi-liquid food, such as various porridge, rice soup and so on.