Liver abscess in children: challenges in management

Digamber Chaubey; Anand Pandey; Piyush Kumar; Archika Gupta; Jiledar Rawat; Ashish Wakhlu; Shiv Narain Kureel

doi:10.18203/2349-2902.isj20164051

Authors

Digamber Chaubey Department of Pediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
Anand Pandey Department of Pediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
Piyush Kumar Department of Pediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
Archika Gupta Department of Pediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
Jiledar Rawat Department of Pediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
Ashish Wakhlu Department of Pediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
Shiv Narain Kureel Department of Pediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20164051

Keywords:

Amoebic liver abscess, Children, Liver abscess, Pyogenic liver abscess, Treatment

Abstract

Background:Liver abscess (LA) is an important cause of morbidity in children. It is more common in developing countries than the developed world. Since it is common in India, we have tried to evaluate the clinical profile of pediatric liver abscess and management protocol.

Methods: This was a retrospective, observational, cohort study. The duration was from February 2011 to August 2016. All the patients with liver abscess were included in it. The patients were evaluated for their complaints, possible predisposing factors, mode of diagnosis, interventions, if any, and duration of stay. Intervention was made according to the ultrasonography abdomen and the number and amount of abscess cavities.

Results:There were 32 patients. The mean age of patients was 5.52 years. The clinical features were fever (25, 78%), pain in right hypochondrium (19, 59%), abdominal distension (4, 12.5%), subacute intestinal obstruction (2, 6.25%), and peritonitis (2, 6.25%). Rupture of abscess was noted in three patients. Conservative management was successful in three patients. USG guided needle aspiration was successful in 5 patients. Pigtail insertion was needed in 21 patients. Laparotomy was performed in three patients. One patient with severe sepsis and coagulopathy expired. All other patients were discharged.

Conclusions:LA is an important cause for morbidity in children. If not taken care of, it may lead to rupture and mortality. High index of suspicion, early screening, and appropriate intervention in form tailored management may fetch good results.

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