A prospective study of the clinical tapestry and strategic management of liver abscess
DOI:
https://doi.org/10.18203/2349-2902.isj20233680Keywords:
Liver abscess, Pigtail, Central IndiaAbstract
Background: Liver abscess is a common condition in India, which has 2nd highest incidence of liver abscess in the world. This study had tried to delineate clinical profile, distribution, mode of presentation, risk factors and effective management of liver abscess.
Methods: Data for this prospective study was obtained from 158 patients with liver abscess and undergoing treatment in a tertiary care center in Central India (Government Medical College and Hospital, Nagpur), from June 2019 to November 2021.
Results: In this study, highest incidence occurred in 31-40 years age group. Abdominal pain was present in all cases. Fever was the most consistent symptom, cryptogenic was the most common etiology, leucocytosis with deranged LFT was seen in majority of cases. Pleural effusion was seen with most common involvement of right side. 12.6% cases (<100 cc) were managed conservatively. 23.5% cases (100-200 cc) were managed with antibiotics along with either aspiration or pigtail drainage. 61.4% cases (>200 cc) were managed with PCD. 2.5% cases showed ruptured liver abscess and were managed surgically. E. coli was the most common organism grown. Incidence of recurrence was 8.2%.
Conclusions: Liver abscess is a common condition in India. All cases don’t require invasive management. Small abscesses can be managed with conservative antimicrobial therapy alone but recurrence rate was seen. Ultrasound guided pigtail catheter drainage is an effective method in majority cases, whereas laparotomy and drainage remain the standard management in complicated ruptured liver abscess into the peritoneal cavity.
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