Not commonly associated with infection

Obstruction > enzymatic self-destruction

Leads to inflammation > pain, fever & elevated WCC

Bile becomes concentrated > irritation/pressure build up, infection, perforation & gram -ve septicaemia

Complications; empyema (pus in space), peritonits (most common from appendicitis), gall bladder gangrene, bile duct damage

Common agents; E. coli, anaerobes

Aetiologies; appendix rupture, diverticular disease, intestinal cancer, cholecystitis, pelvic inflammatory disease

Differentiate from; acute pancreatitis, cholecystitis, liver disease, mesenteric adenitis (lymph enlargement), shingles (w/ rash)

Treatment with broad spectrum antibiotics

Spread via haematogenous (blood) or contiguous (continued spread)

Aetiology; mixed bacterial microbes (reqs. broad sprectrum antibiotic), amoebic dysentry may also cause (treat with Flagyl against protozoa)

Lymph node inflammation

Aetiologies; viral & bacterial GIT infections

Aetiology; hydatid infection from hydatid eggs from dogs

Cysts may form in liver, lungs or brain

Liver structure defect > portal hypertension > obstructed blood flow > ascites

Aetiology; anything that can cause obstruction or altered structure (I.e Schistosomes effecting liver & bladder)

Aetiological factors; Hepatits A-G, EBV (glandular fever/kissing's disease), yellow fever, leptospirosis

Differentiate previous infection from new by presence of IgG (old infection) or IgM (new infection)

- HAV; presents as a naked-virus (no lipid layer, only a protein coat) = allowing environmental stability, acquired via faecal-oral route, detected with elevated liver enzymes (inflammation), vaccine available

- HBV ('Serum hepatits'); virus causes no inflammation, damage mediated by cytotoxic T cells, can directly cause cancer (HBV > genetic incorporation > cancer), evades the immune system by producing surface antigen particles  acting as decoys (empty core) which 'sook' up antibodies, death occurs in chronically infected from cirrhosis or hepatoma, spreads via blood/semen, 95% chance of being life-ling carrier if infected at birth, HBV vaccine available (empty shell = safe)

- HCV; primary spread via intravenous drug users & household spread, no vaccine, presents as a milder disease, likely to progress to chronic infection > liver failure/cirrhosis/hepatoma