Study of clinical presentation, management and prognosis of liver abscess

Authors

  • S. Surendran Department of General Surgery, Government Medical College Hospital Ramanathapuram, Tamil Nadu, India
  • V. Vallipriya Department of General Surgery, Government Medical College Hospital Ramanathapuram, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20221336

Keywords:

Liver abscess, Pyogenic liver abscess, ALA, Single/ multiple aspiration

Abstract

Background: The term "liver abscess" refers to a collection of pus in the parenchyma of the liver mainly due to the infection of microorganisms. If a liver abscess is not diagnosed early or not treated, it can be fatal, resulting in significant morbidity and mortality. Aim of the study was to study the clinical manifestations, aetiologies, and management of liver abscesses in tertiary care hospital patients.

Methods: From March 2015 to August 2016, 99 patients with liver abscesses were studied in the general surgery wards of government Rajaji hospital in Madurai. In the beginning, routine examination history and blood tests were documented. Then, an ultrasound was performed in selected cases, and further treatment was performed.

Results: In the current study, the most cases (48%) were from the age group of 41-50 years. We discovered that this disease is more common in men (97.97%), mainly with a history of alcohol intake, with an amoebic liver abscess (ALA) in 95% of cases. Abdominal pain (100%) and fever (57%) were the most common symptoms observed in the patients. For treatment, we used single aspiration in 30 (30.3%) cases, percutaneous catheter drainage in 25 (25.25%) cases, laparotomy and drainage in 22 (22.22%) cases, multiple aspirations in 19 (19.09%) cases, and conservative management in 3 (3.03%) of the cases.

Conclusions: Liver abscesses are most commonly found in young males with a history of alcohol consumption. Unfortunately, it is still a disease that causes significant morbidity. To successfully manage the liver abscess aspiration, catheter drainage and laparotomy with drainage can be used, whether single or multiple.

References

Khim G, Em S, Mo S, Townell N. Liver abscess: diagnostic and management issues found in the low resource setting. Br Med Bull. 2019;132:45-52.

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

Serraino C, Elia C, Bracco C, Rinaldi G, Pomero F, Silvestri A et al. Characteristics and management of pyogenic liver abscess: A European experience. Medicine (Baltimore). 2018;97:e0628.

Kurland JE, Brann OS. Pyogenic and amebic liver abscesses. Curr Gastroenterol Rep. 2004;6:273-9.

Lübbert C, Wiegand J, Karlas T. Therapy of liver abscesses. Viszeralmedizin 2014;30:334-41.

Abdullah AA, DM F. Clinical analysis of Amebic Liver Abscess in Sulaimany governorate. Age (years). 2005;37:19.

Mukhopadhyay M, Saha AK, Sarkar A, Mukherjee S. Amoebic liver abscess: presentation and complications. Indian J Surg. 2010;72:37-41.

Sharma N, Sharma A, Varma S, Lal A, Singh V. Amoebic liver abscess in the medical emergency of a North Indian hospital. BMC Res Notes. 2010;3:21.

Makkar RPS, Sachdev GK, Malhotra V. Alcohol consumption, hepatic iron load and the risk of amoebic liver abscess: a case-control study. Intern Med. 2003;42:644-9.

Pang TCY. Pyogenic liver abscess: An audit of 10 years' experience. World J Gastroenterol. 2011;17:1622.

Ghosh S, Sharma S, Gadpayle AK, Gupta HK, Mahajan RK, Sahoo R et al. Clinical, laboratory, and management profile in patients of liver abscess from northern India. J Trop Med. 2014;2014:142382.

Kebede A, Kassa E, Ashenafi S, Woldemichael T, Polderman AM, Petros B. Amoebic liver abscess: A 20-year retrospective analysis at Tikur Anbessa Hospital, Ethiopia. Ethi J Health Development. 2004;18(3):199-202.

Qazi AR, Naqvi S, Solangi RA. Liver abscess: diagnosis and treatment. Pak J Surg. 2008;24:203-6.

Muthukumarasamy H, Ramakrishnan R. Liver abscess-anatomical correlation. Anatomica Karnataka 2011;5:81-6.

Zerem E, Hadzic A. Sonographically guided percutaneous catheter drainage versus needle aspiration in the management of pyogenic liver abscess. AJR Am J Roentgenol. 2007;189:W138-42.

McGarr PL, Madiba TE, Thomson SR, Corr P. Amoebic liver abscess--results of a conservative management policy. S Afr Med J. 2003;93:132-6.

Ramani A, Ramani R, Kumar MS. Ultrasoundguided needle aspiration of amoebic liver abscess. Postgrad Med J. 1993;69:381-3.

Downloads

Published

2022-05-26

Issue

Section

Original Research Articles