A.BACKGROUND OF THE STUDY liver abscess is a pus-filled mass inside or attached to the liver.

A liver abscess occurs when bacteria or protozoa destroy hepatic tissue, producing a cavity, which fills with infectious organisms, liquelled liver cells, and leukocytes. Necrotic tissue then walls off the cavity from the rest of the liver. Common causes are abdominal infections such as appendicitis or diverticulitis due to haematogenous spread through the portal vein. Liver abscess occurs equally in men and women, usually in those over age 50. As the diagnosis and its treatment has improved, it remains the only cause in 10% of abscesses.Death occurs in 15% of affected patients despite treatment. There are three major forms of liver abscess, classified by *Fungal abscess, most often due to Candida species, accounts for less than 10% of cases. *Amoebic liver abscess due to Entamoeba histolytica accounts for 10% of cases. *But the most common is.Pyogenic liver abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess.

Risk factors DM, underlying hepatobiliary or pancreatic malignancy, and liver transplant. Geographic factors may also play a role. mortality rate : 2 ~ 12% (mortality appears to be related to underlying comorbidities rather than to the abscess itself.) Causes

Abdominal infection such as appendicitis, diverticulitis, or a perforated bowel Infection in the blood Infection of the bile draining tubes Recent endoscopy of the bile draining tubes Trauma that damages the liver.

Symptoms

Clay-colored stool Dark urine Fever, chills Loss of appetite Nausea, vomiting Pain in right upper abdomen (more common) or throughout the abdomen (less common) Unintentional weight loss Weakness Yellow skin (jaundice)

Signs: Fever and tender hepatomegaly -the most common signs. A palpable mass need not be present. Mid epigastric tenderness, with or without a palpable mass, is suggestive of left hepatic lobe involvement. Decreased breath sounds in the right basilar lung zones, with signs of atelectasis and effusion on examination or radiologically, may be present. . Jaundice may be present in as many as 25% of cases and usually is associated with biliary tract disease or the presence of multiple abscesses The right hepatic lobe is affected more often than the left hepatic lobe by a factor of 2:1. Bilateral involvement is seen in 5% of cases. The predilection for the right hepatic lobe can be attributed to anatomic considerations. The right hepatic lobe receives blood from both the superior

mesenteric and portal veins, whereas the left hepatic lobe receives inferior mesenteric and splenic drainage. It also contains a denser network of biliary canaliculi and, overall, accounts for more hepatic mass. Studies have suggested that a streaming effect in the portal circulation is causative.

B. RATIONALE FOR THE CHOOSING THE CASE We choose the case of liver abscess because of the following reason
1. To have an in depth knowledge regarding liver

abscess case.
2. To know the medical and nursing management

administer in liver abscess.

3. To impart knowledge to others about liver

abscess. C. SIGNIFICANCE OF THE STUDY Student Nurse This case study will help the group in understanding the disease process of the patient. This would also help the group in identifying the primary needs of the patient with liver abscess. By identifying such needs and health problems arise the group can now formulate an individualized care plan for the pt. that would address these needs and problem affectively. Client This case study will help the patient to understand the situation of her present state, this would allow her to be more aware of the importance of following the treatment regimen.

Family With this study, the family provides a wonderful support from the client. Community This study is significant to the people in the community because they will be able to explore more the dease,especially because it was the leading cause of mortality rate in the Philippines. 4.