Assessment of outcome and complications of ultrasonography guided pigtail catheter drainage in management of liver abscess


  • Anil K. Errey Department of General Surgery, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India
  • Santosh K. Singh Department of General Surgery, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India
  • Neha Sachan Department of Community Medicine, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India
  • Vandana Singh Department of General Surgery, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India



Liver abscess, Complications, Pigtail catheter, Percutaneous drainage


Background: Liver abscess (LA) is defined as an encapsulated collection of suppurative material within the liver parenchyma. Liver abscesses are most commonly due to bacterial, amoebic or mixed infections. Less commonly these may be fungal in origin. Liver abscess are associated with mortality of up to 20% and are categorized into various types based on aetiology, of which amoebic (ALA) and pyogenic (PLA) liver abscess are major types. The objective is to evaluate and assess the response of percutaneous pigtail catheter drainage in treatment of liver abscess and to document the complications of liver abscess (LA).

Methods: The study was conducted on patients who were admitted from casualty and outpatient department with a diagnosis of liver abscess (LA). 100 patients of LA were included in the study. They were divided into two groups. Group 1 consists of LA patients without associated complications and Group 2 consists of LA patients with associated complications like rupture, jaundice, IVC compression, persistent or recurrent LA.

Results: There were 88% males and 12% were females in the study. 30% patients had complications. Out of them, 14 (46.6%) patients of LA presented with intra-peritoneal rupture. 12 (40%) with jaundice, 2 (6.7%) with rupture into pleural cavity and 2 (6.7%) patients had IVC compression. (70%) had involvement of right lobe while minimum patients (12.9%) had bilateral lobe involvement in group 1 and (10%) had involvement of left lobe of liver in group 2.

Conclusions: Pigtail insertion and percutaneous catheter drainage (PCD) of abscesses, peritoneal or pleural cavity are safe procedures. PCD is a good alternative to open surgical drainage.


Heneghan HM, Healy NA, Martin ST, Ryan RS, Nolan N, Traynor O, et al. Modern management of pyogenic hepatic abscess: a case series and review of the literature. BMC Res Notes. 2011;4(1):80.

Huang CJ, Pitt HA, Lipsett PA, Osterman FA, Lillemoe KD, Cameron JL, et al. Pyogenic hepatic abscess: changing trends over 42 years. Ann Surg. 1996;223(5):600-9.

Lee KT, Wong SR, Sheen PC. Pyogenic liver abscess: an audit of 10 years’ experience and analysis of risk factors with invited commentary. Dig Surg. 2001;18(6):459-66.

Kumar D, Ramanathan S, Faki AA, Nepal P. Faecolith migrating from the appendix to produce liver abscess after subhepatic laparoscopic appendectomy. Trop Doct. 2015;45(4):241-4.

Law ST. Is hepatic neoplasm-related pyogenic liver abscess a distinct clinical entity? World J Gastroenterol. 2012;18(10):1110.

Murarka S, Pranav F, Dandavate V. Pyogenic liver abscess secondary to disseminated Streptococcus anginosus from sigmoid diverticulitis. J Glob Infect Dis. 2011;3(1):79.

Abbas MT, Khan FY, Muhsin SA, Dehwe AB, Abukamar M, Elzouki AN. Epidemiology, clinical features and outcome of liver abscess: a single reference center experience in Qatar. Oman Med J. 2014;29(4):260-3.

Deguelte LS, Ragot E, Amroun K, Piardi T, Dokmak S, Bruno O, et al. Hepatic abscess: diagnosis and management. J Visc Surg. 2015;152(4):231-43.

Keller JJ, Tsai MC, Lin CC, Lin YC, Lin HC. Risk of infections subsequent to pyogenic liver abscess: a nationwide population-based study. Clin Microbiol Infect. 2013;19(8):717-22.

Italiya HB, Shah PR, Rajyaguru AM, Bhatt JG. A prospective study of USG guided pigtail catheter drainage in management of liver abscess. Int J Res Med Sci. 2015;3(3):574-8.

Sabiston DC, Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston textbook of surgery: the biological basis of modern surgical practice. 20th edition. Philadelphia, PA: Elsevier; 2017: 2146.

Trump DL, Fahnestock R, Cloutier CT, Dickman MD. Anaerobic liver abscess and intrahepatic metastases. A case report and review of the literature. Cancer. 1978;41(2):682-6.

Shin JU, Kim KM, Shin SW, Min SY, Park SU, Sinn DH, et al. A prediction model for liver abscess developing after transarterial chemoembolization in patients with hepatocellular carcinoma. Dig Liver Dis. 2014;46(9):813-7.

Jha AK, Das A, Chowdhury F, Biswas MR, Prasad SK, Chattopadhyay S. Clinicopathological study and management of liver abscess in a tertiary care center. J Nat Sci Biol Med. 2015;6(1):71.

Zafar A, Ahmed S. Amoebic liver abscess: a comparative study of needle aspiration versus conservative treatment. J Ayub Med Coll Abbottabad. 2002;14(1):10-2.

Mohsen AH, Green ST, Read RC, McKendrick MW. Liver abscess in adults: ten years experience in a UK centre. QJM. 2002;95(12):797-802.

Sarda AK, Mittal R, Basra BK, Mishra A, Talwar N. Three cases of amoebic liver abscess causing inferior vena cava obstruction, with a review of the literature. Korean J Hepatol. 2011;17(1):71-5.

Blessmann J, Van Linh P, Nu PAT, Thi HD, Muller-Myhsok B, Buss H, et al. Epidemiology of amebiasis in a region of high incidence of amoebic liver abscess in central Vietnam. Am J Trop Med Hyg. 2002;66(5):578

Cosme A, Ojeda E, Zamarreño I, Bujanda L, Garmendia G, Echeverría MJ, et al. Pyogenic versus amoebic liver abscesses. A comparative clinical study in a series of 58 patients. Rev Esp Enferm Dig. 2010;102(2):90-9.

Memon AS, Siddiqui FG, Memon HA, Ali SA. Management of ruptured amoebic liver abscess: 22 years’ experience. J Ayub Med Coll Abbottabad. 2010;22(2):96-9.

Sharma MP, Sarin SK. Evaluation of parameters of cure in Amoebic liver abscess. J Assoc Physicians India. 1983;31(11):719-20.

Nigam P, Gupta AK, Kapoor KK, Sharan GR, Goyal BM, Joshi LD. Cholestasis in amoebic liver abscess. Gut. 1985;26(2):140-5.

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(4):332-9.






Original Research Articles