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Suggest Treatment For Recurring Liver Abscesses
My husband has been fighting recurring liver abscesses following open gallbladder removal in November. He has hadseveral drain tubes in the abscesses, had a partial resection of the left hepatic lobe, had a feeding tube placed due to severe malnutrition and dehydration, and been treated for multiple bacterial infections. After seemingly being on the road to recovery for a month, he began to run fever (102+) over Memorial Day weekend. CT scan last week showed 2 new abscess on the right hepatic lobe. Once again he is unable to eat, losing weight and malnourished, even though he is taking megase and synthetic cannibus. He has been unable to swallow nutrition drinks (mental or physical?) Is there anything I can do to help him eat; anything that he can try in small portions that might provide sufficient nutrition?
posted on
Sun, 14 Jun 2015
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Tue, 10 Nov 2020
Answered on
Fri, 13 Nov 2020
Last reviewed on
Hi,
This is a tough situation, it is very difficult to completely eradicate all of the bacteria causing the abscesses and I feel this is likely the reason why they continue to recur. As far as appetite stimulants you are essentially the best ones already on board, Megace and S-THC. One option which may be the best solution is to ask the surgeon to consider Total Parenteral Nutrition (TPN). You may already know about this, but it involves inserting a large catheter in one of the veins and essentially feeding him intravenously. This bypasses the liver (largely) and this would allow time for him to recuperate and regain some muscle mass and fat stores.
This is not a permanent solution but it would allow some recovery time. The abscess will likely need a very very long course of IV antibiotics to eradicate or at least contain the infection and this would provide the nutrients needed to allow him to better fight the bacterial abscesses along with the antibiotics. He may not be able to surgically remove the infection but it may in fact be a scenario of trying to get ahead of it and then keeping it bay with intermittent antibiotic use.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. David Girardi, Internal Medicine Specialist
This is a tough situation, it is very difficult to completely eradicate all of the bacteria causing the abscesses and I feel this is likely the reason why they continue to recur. As far as appetite stimulants you are essentially the best ones already on board, Megace and S-THC. One option which may be the best solution is to ask the surgeon to consider Total Parenteral Nutrition (TPN). You may already know about this, but it involves inserting a large catheter in one of the veins and essentially feeding him intravenously. This bypasses the liver (largely) and this would allow time for him to recuperate and regain some muscle mass and fat stores.
This is not a permanent solution but it would allow some recovery time. The abscess will likely need a very very long course of IV antibiotics to eradicate or at least contain the infection and this would provide the nutrients needed to allow him to better fight the bacterial abscesses along with the antibiotics. He may not be able to surgically remove the infection but it may in fact be a scenario of trying to get ahead of it and then keeping it bay with intermittent antibiotic use.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. David Girardi, Internal Medicine Specialist
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