A study of treatment outcomes of liver abscess in a rural tertiary care centre


  • Pooja Reddy Department of General Surgery, PESIMSR, Kuppam, Andhra Pradesh, India
  • Ashwin K. Department of General Surgery, PESIMSR, Kuppam, Andhra Pradesh, India
  • N. Srinivasan Department of General Surgery, PESIMSR, Kuppam, Andhra Pradesh, India
  • Manjush Ramesh Halbhavi Department of General Surgery, PESIMSR, Kuppam, Andhra Pradesh, India




Liver abscess, Percutaneous catheter drainage, Percutaneous needle aspiration, Ultrasonography


Background: Liver abscess is a cavity resulting from suppuration following invasion and multiplication of microorganisms. In tropical countries like India, pyogenic and amoebic liver abscesses are common clinical problems and an important cause of mortality and morbidity. Approach in management has changed with advances in radiological interventions. Image guided percutaneous drainage is nowadays increasingly used as treatment modality with high success rate. This study was undertaken to know the efficacy of various modalities of treatment (conservative and minimally invasive).

Methods: This was a descriptive prospective observational study done at PES Institute of Medical Sciences and Research, Kuppam for a period of 2 years. A set of inclusion and exclusion criteria were defined and followed. Initial assessment, basic investigations with specific investigations (Ultrasonography-USG) were done. Relevant treatment modality was given and patients were followed up for a period of 1 month.

Results: A total of 72 patients were included in this study. Majority of the patients were between the age groups of 31 to 50 years with male predominance. The most common presenting symptoms were fever and pain abdomen. Success rate was 83.3% with Percutaneous needle aspiration (PNA) and 90% with Percutaneous (pigtail) catheter drainage (PCD).

Conclusions: Image guided modalities of treatment (PNA and PCD) have decreased the need for surgical procedures which are associated with higher rate of morbidity and mortality. These procedures have also decreased the complications of liver abscess like rupture, sepsis and are also cost-effective.


Huang C-J, Pitt HA, Lipsett PA, Osterman FA Jr, Lillemoe KD, Cameron JL et al. Pyogenic hepatic abscess. Ann Surg. 1996;223(5):600–9.

Giorgio A, Tarantino L, Mariniello N, Francica G, Scala E, Amoroso. P et al. Pyogenic liver abscess: 13 years of experience in percutaneous needle aspiration with US guidance. Radiol. 1995;195:122–4.

Kurland, J, Brann, O. Pyogenic and amebic liver abscesses. Current Gastroenterology Reports. 2004;6(4):273-9.

Peralta, R. Primary Pyogenic Liver Abscess: Current Treatment Options. Internet J Surg. 2009;18(1).

Berger LA, Osborne DR. Treatment of pyogenic abscesses by percutaneous drainage. Lancet. 1982;1:132–4.

Gerzof SG, Johnson WC, Robbins AH, Nabseth DC. Intrahepatic pyogenic abscesses: treatment by percutaneous drainage. Am J Surg. 1985;149:487–94.

Attar B, Levendoglu H, Cuasay NS. CT-guided percutaneous aspiration and catheter drainage of pyogenic liver abscesses. Am J Gastroenterol. 1986;81:550–5.

Seeto RK, Rockey DC. Pyogenic liver abscess. Changes in etiology, management, and outcome. Medicine (Baltimore). 1996;75:99–113.

Rintoul R, O'Riordain MG, Laurenson IF, Crosbie JL, Allan PL, Garden OJ. Changing management of pyogenic liver abscess. Br J Surg. 1996;83:1215–8.

Ch Yu S, Hg Lo R, Kan PS, Metreweli C. Pyogenic liver abscess: treatment with needle aspiration. Clin Radiol. 1997;52:912–6.

Rajak CL, Gupta S, Jain S, Chawla Y, Gulati M, Suri S. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage. Am J Roentgenol. 1998;179:1035–9.

Cook GC. Gastroenterological emergencies in the tropics. Baillieres Clin Gastroenterol. 1991;5:861–86.

Reeder MM. Tropical diseases of the liver and bile ducts. Semin Roentgenol. 1975;10:229–43.

Chou, F., Sheen-Chen, S., Chen, Y. and Chen, M. Single and Multiple Pyogenic Liver Abscesses: Clinical Course, Etiology, and Results of Treatment. World J Surg. 1997:21(4); 384-9.

Saini, S. Imaging of the Hepatobiliary Tract. New England J Med. 1997:336(26);1889-94.

Singh S, Chaudhary P, Saxena N, Khandelwal S, Poddar DD, Biswal UC. Treatment of liver abscess: prospective randomized comparison of catheter drainage and needle aspiration. Ann Gastroenterol. 2013;26:332-9.

Târcoveanu E, Vlad N, Moldovanu R, Georgescu St, Bradea C, Lupaşu C, et al. Pyogenic liver abscesses. Chirurgia (Bucur). 2008;103(4):417-27.

Amin AB, Patel RD, Doshi C, Bhuva AV. A comparative study of different modalities of treatment of liver abscess. IAIM. 2015;2(4):11-6.

Hughes MA, Petri WA., Jr Amebic liver abscess. Infect Dis Clin North Am. 2000;14:565–82.

Chiu CT, Lin DY, Wu CS, Chang-Chien CS, Sheen IS, Liaw YF. A clinical study on pyogenic liver abscess. Taiwan Yi Xue Hui Za Zhi. 1987;86:405–12.

Barnes PF, De Cock KM, Reynolds TN, Ralls PW. A comparison of amebic and pyogenic abscess of the liver. Medicine (Baltimore). 1987;66:472–83.

Rehman M, Aashish K, Anil .B. K. Clinical & Pathological Study of Management of Liver Abscess by Continuous Percutaneous Drainage Using Malecot’s Catheter. J Medic Dental Sci Res. 2016;3(9):13-7.

Rajak CL, Gupta S, Jain S, Chawla Y, Gulati M, Suri S. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage. AJR. 1998;170:1035–9.

Baek SY, Lee MG, Cho KS, Lee SC, Sung KB, Auh YH. Therapeutic percutaneous aspiration of hepatic abscesses: effectiveness in 25 patients. AJR. 1993;160:799–802.

Dietrick RB. Experience with liver abscess. Am J Surg. 1984;147:288–91.

Saraswat VA, Agarwal DK, Baijal SS. Percutaneous catheter drainage of amoebic liver abscess. Clin Radiol. 1992;45:187–9.

Gupta SS, Singh O, Sabharwal G, Hastir A. Catheter drainage versus needle aspiration in management of large (>10 cm diameter) amoebic liver abscesses. ANZ J Surg. 2011;81:547–51.






Original Research Articles