CLINICOPATHOLOGICAL STUDY AND MANAGEMENT OF LIVER ABSCESS

Abstract

Introduction: Liver abscess though not common in prevalence presents a challenging situation to the physicians. It is potentially curable but invariably life threatening if left untreated promptly. Abscess of liver has undergone tremendous changes in mortality, management due to advancement and refinement in the treatment from past few decades.

Materials and Methods: This study was carried out in a big centre in northern India on 100 patients over a time span of 3 years. In this study, various parameters like symptoms/signs, investigations, treatment options and complications occurring in cases of liver abscess were studied.

Results: In our study, 4th decade was the most common age group with oldest patient admitted 67 years of age and youngest patient admitted was 6 years old, males were more common than females. Bacterial liver abscess was most predominant abscess and fever was the most common symptom and sign. Right upper quadrant tenderness 69%, patients, and hepatomegaly 37% of patients. Elevated total leukocyte count 64%, bilirubin 20%, ALP 88%, SGOT/PT 53%. Right lobe abscesses were more common with solitary abscess in 75%. Biliary route was the commonest entry of infection. Gram negative was the commonest bacteria identified and thrombophlebitis was the most common complication. Percutaneous drainage was the modality of treatment in most of the patients.

Conclusion: Most patients in our study had liver abscess of bacterial origin with biliary aetiology. Early recognition of clinical features, Ultrasonography (USG), CECT is cost effective means of treatment initiation and thus reduces complications.