Liver abscess, management strategies, and outcome

Abstract

Background: Liver abscess, a disease troubling mankind from ancient times, has earliest documentation in the Sanskrit document. Where right upper abdominal pain, have potentially lethal consequences, if prompt diagnosis and treatment are not accomplished. However, two major types are known, amoebic and pyogenic, in medical literature. Pyogenic liver abscess constitutes major bulk of hepatic abscess in western countries. The diagnosis is confirmed by ultrasonography, reddish brown (anchovy-paste like material) aspirate from abscess. The diagnosis, treatment and prognosis, of liver abscess have evolved remarkably over past few years. Imaging has improved diagnostic competence and has altered therapeutic strategy. The study aims at early clinical and diagnosis on imaging of liver abscess, to set up some guide lines in view of conservative or either intervention.Methods: The present study was hospital based longitudinal study, carried out in tertiary care teaching hospital from November 2013 to November 2015. A total of 55 patients were enrolled in the study. All patients with suspicion of having liver abscess were confirmed on Imaging and included as present study population. Authors studied mainly presentation, role of conservative treatment, Aspiration, pigtail catheter, Outcome, and post procedural complications.Results: All patients presented with Pain right or left upper abdominal pain in abdomen, any chest complaints , majority of present study group patients had fever with or without rigors, deranged liver function. Imaging is the most diagnostic method, and also helped in therapy and follow up.Conclusions: Males are affected more than females, Imaging is the best modality for diagnosis, therapy and follow up. Aspiration or pigtail drainage is the standard method of drainage. Pigtail drainage is the better method of treatment than aspiration.

Right Upper Quadrant Pain in a World Explorer

“…3 Anchovy-paste consistency and color of the fluid is pathognomonic for amebic liver abscesses. 5 Metronidazole is the recommended agent against active infection followed by an intraluminal agent such as paromomycin to cure the patient of the carrier state. 6 Overall, the patient in this study had several classic historical features and symptoms for Entamoeba and received the recommended medical and catheter-directed treatment.…”

Large Solitary Pyogenic Liver Abscesses: A Review of Their Management at a Tertiary Care Hospital

“…USG-guided drainage is usually recommended for pyogenic liver abscesses while guided aspiration is performed for amoebic liver abscess as indicated [12]. There are several studies in the literature on pyogenic liver abscesses, which have generally shown that PCD is better than aspiration given its higher success rate, shorter time for abscess volume reduction, and faster clinical recovery [13][14][15]. However, a few studies have suggested that percutaneous aspiration leads to equally good results compared to percutaneous drainage [16,17].…”