Recurrent or refractory abscesses

Recurrent or refractory abscesses

Recurrent abscesses usually occur when the initial lesion was large, abscesses were multiple or there is continued commu - nication with the biliary tract. It can be di ffi cult to confirm whether a liver abscess is recurrent or new , but it is important - as treatment di ff ers. Recurrent lesions which wer e aspirated and treated with antibiotics can be re-aspirated, but a drain is often required. Refractory lesions should have microbiology repeated and a drain inserted, and recurrences are rare if left until resolution is complete. If unsuccessful occasionally surgery is required, and laparoscopy which allows a full examination of the peritoneal cavity (especially valuable when the source has not been identified) has replaced laparotomy .