Clinico-pathological profile of liver abscess: a prospective study of 100 cases

Abstract

Background: Liver abscess is a constant source of mortality and morbidity in general and tropical countries. India has second highest incidence of Liver abscess. This study were planned to identify the clinical profile of liver abscess in terms of demographic profile, clinical presentation, etiology, evaluation of different modalities of investigations, effectiveness of various treatment modalities and to study influence of alcohol and diabetes.

Methods: This study was carried out in a tertiary care centre in Northern India between the period of January 2013 to June 2014. An attempt was made in this study to define the various symptoms complex, treatment options and complications occurring in cases of liver abscess.

Results: In our study highest incidence occurred in 31-60 years age group (71%). Males were more commonly affected (92%). Abdominal pain (98%) was the most common symptom. Alcohol was the single most common etiological factor in 84% of cases of Liver abscess. Laboratory investigations were leucocytosis (72%), anaemia (23%), Raised B. Urea (21%), RBS >200mgm% (29%), raised alkaline phosphatase (83%), hypoalbuminemia (84%), PT >20sec (29%), raised SGOT (52%), SGPT (45%). Aspirated pus culture from liver abscess was sterile in 59.45% cases suggestive of amoebic etiology. Ultrasonography revaled solitary abscess in 78%. Isolated Right Lobe abscess was seen in 74%.72% of patients were subjected to percutaneous aspiration in abscess >100 ml or >3 cm; Recurrences were noted in 8% of cases in conservative management group.

Conclusions: Amoebic abscess is much more common than pyogenic liver abscess. Lack of proper sanitary condition, DM and addiction to alcohol are the most important predisposing condition for liver abscess. Ultrasound is simple, inexpensive and quick to perform, with a diagnostic accuracy of 90%.