CLINICOPATHOLOGICAL STUDY AND MANAGEMENT OF LIVER ABSCESS

Shamima Akhter, Mumtazudin Wani, Showkat Jeelani, Fouzia Rasheed

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.

Keywords


Bacterial liver abscess, Pigtail catheter drainage, Percutaneous drainage, Clinocopathological study, Liver abscess, Pyogenic abscess.

References


Altmeier WA, Schowengerdt CG, and Whiteley DH. (1970). “Abscesses of the liver: surgical considerations”, Arch. Surg, Vol.101, pp.258-266.

Chan KS, Chen CM, Cheng KC, Hou CC, Lin HJ, and Yu WL. (2005). “Bacterial liver abscess: A retrospective analysis of 107 patients during a 3-year period”, Jpn J Infect Dis, Vol.58, pp.366-368.

Chou FF, Sheen-Chen SM, Chen YS, Chen MC, Chen FC, and Tai DI. (1994). “Prognostic factors for pyogenic abscess of liver”, Journal American College of Surgeons, Vol.179, pp.727-732.

Gyorffy EJ, Frey CF, Silva J Jr, and McGahan J. (1987). “Bacterial liver abscess. Diagnostic and therapeutic strategies”, Ann Surg, Vol.206(6), pp.699-705.

Lee KT, Wong SR, and Sheen PC. (2001). “Pyogenic liver abscess: an audit of 10 years’ experience and analysis of risk factors”, Dig. Surg, Vol.18, pp.459-465.

Mathur S, Gehlot RS, Mohta A, and Bhargava N. (2002). “Clinical profile of amoebic liver abscess”, J Indian Acad Clin Med, Vol.3, pp.367-373.

Mehta RB, Parija SC, and Hamba H, et-al. (1986). “Management of 240 cases of liver abscess”, International Surgery, Vol.71, pp.91-94.

Pillai DR, Keystone JS, Sheppard DC, MacLean JD, MacPherson DW, and Kain KC. (1999). “Entamoeba histolytica and Entamoeba dispar: Epidemiology and comparison of diagnostic methods in a setting of nonendemicity”, Clin Infect Dis, Vol.29, pp.1315-1318.

Pitt HA, and Zuidema GD. (1975). “Factors influencing mortality in the treatment of bacterial hepatic abscesses”, Surg. Gynecol. Obstet, Vol.140, pp.228-234.

Rahimian J, Wilson T, Oram V, and Holzman RS. (2004). “Pyogenic liver abscess; recent trends in etioogy and morality”, Clin.Infect Dis, Vol.39, pp.1654-1759.

Rajak CL, Gupta S, and Jain S. (1998). “Percutaneous Treatment of liver abscess. Needle aspiration versus Catheter drainage”, American Journal of Roentgenology. Vol.170, pp.1035-1039.

Rubin H, and Isikoff M, et-al. (1974). “Diagnostic imaging of hepatic liver abscess”, American Journal of Radiology, Vol.135, pp.735-40.

Seeto RK, and Rockey DC. (1996). “Bacterial liver abscess. Changes in etiology, management and outcome medicine”, Journal of Medicine, Vol.75, pp.99-113.

Sherman JD, and Robbins SL. (1960). “Changing trends in the casuistic of hepatic abscess”, Am. J. Med, Vol.28, pp.943-980.

Shimada H, and Ohta S, et al. (1994). “Diagnostic and therapeutic strategies of Pyogenic liver abscess”, International Journal of Surgery, Vol.28, pp.943-950.


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