Liver abscess may be present without demonstrable lesions in the large intestines, such lesions having healed or the intestinal involvement having been so slight as not to have caused other than microscopic changes.
It is a well-known fact that liver abscess may set in years after a patient has left the tropics and years after the occurrence of any dysenteric manifestations.
Pathology
There seems little doubt but that the amoebae in the thrombosed terminals of the portal vein are carried by way of the upward current into the liver where they lodge in the liver capillaries, Councilman and Lafleur having found amoebae in such emboli.
Another view is that the amoebae may wander across the abdominal cavity and enter the liver in this way. This seems as improbable as that view which considers a possible entrance by way of the bile duct. Bile is toxic to amoebae and it would be difficult to explain their presence in the small intestines.
In 639 cases Roux found the abscess in the right lobe in 70% of the cases.
Other statistics give about 75% for the right lobe, 10% for the left lobe, 4% for the lobus Spigelii and in about 10% of cases abscesses are found in both right and left lobes.
In 562 cases Zancarol found a single abscess in 60% of the cases.
In 288 cases Waring found a single abscess in 61.5%, double abscesses in 11.5% and multiple abscesses in 27%. The favorite site of liver abscess is the superior and posterior part of the right lobe and near its surface.