Liver abscess-various modalities of treatment and its clinical outcome

Christopher, Sathish; Kumar, Anil; Achar, Srinivas

doi:10.18203/2349-2902.isj20162826

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…Christopher et al reporter 40% cases with antibiotics alone, 21.42% cases were treated with antibiotics and aspiration 38.57% cases were subjected to catheter drainage. 15 In our study 74% of patients were found to give amoebic liver abscess and 26% of patients were found to have pyogenic liver abscess. Oschner and colleagues reporter in 1938 that amoebic liver abscessis three times more common than pyogenic liver abscesses.…”

Section: Discussionmentioning

confidence: 44%

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Prospective study of etiology of liver abscess and comparison of different ways of its management

2020

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Background: Liver abscess is a collection of purulent material in the liver parenchyma which can be due to bacterial, parasitic, fungal or mixed infection. It has become one of the most common communicable disease with much more prevalence in underdeveloped and developing countries. Two most common type of liver abscess are amoebic and pyogenic. Pyogenic liver abscess is more common in western world while amoebic liver abscess is more commonly found in third world countries, which are under developed, and more people living under lower socio economic conditions.Methods: A prospective study of 50 patients with clinical diagnosis of liver abscess admitted in the department of surgery B. R. D. Medical College Gorakhpur during a period of one year.Results: There was male predominance (98%) and most of the patient belongs to younger age group and low socio economics status. In amoebic liver abscess there was strong correlation with alcohol intake (66%).Conclusions: In our study most of the patients were group 21-30 years and the most common presenting symptom was right upper quadrant pain and fever. In most of the patients, the common hematological finding was mild anaemia with leucocytosis with altered LFT.

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Section: Discussionmentioning

confidence: 44%

“…7 Other symptoms such as chills and rigour present in 32% of cases, which was near to Christopher et al study who found only chills in 41.42%. 15 and Kempraj et al who found chills rigour in majority of cases i.e., 67%. 3 Icterus in 38% while Kampraj et al found icterus in 20% cases and Maheshwari et al in 16% cases.…”

Section: Discussionmentioning

confidence: 89%

Prospective study of etiology of liver abscess and comparison of different ways of its management

2020

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“…While metronidazole has remained the cornerstone of management of ALA since its acceptance, various studies have demonstrated early recovery with drainage of the abscess. 6 8 9 15 16 In the later stages ALA usually consists of acellular proteinaceous debris, and a brown fluid which is likened to “Anchovy Paste” consisting of necrotic hepatocytes. A 10 Fr pigtail catheter becomes nonfunctional due to blockage which may require repeated flushing which in turn can introduce secondary infections.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Drainage Protocol in Large Amoebic Liver Abscess

Gandhi

Shinde²,

Chaudhari³

et al. 2021

Surg J (N Y)

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Background Amebic liver abscess (ALA) contributes significantly to morbidity and mortality in patients of the developing world. Even though medical management is the primary modality of treatment, 15% of the cases are refractory and require intervention for drainage. Pigtail catheterization is inefficient and results in a long duration of hospital stay. So, we conducted a prospective observational study to determine the efficacy and safety of drainage of large ALA using a wide bore 24 French (Fr) drain compared with a conventionally used 10 Fr pigtail catheter. Materials and Methods A single center prospective observational study was conducted over a period of 5 years and data of 122 patients was collected. After starting empirical medical therapy, patients underwent drainage of ALA with either a 10 French pigtail or a 24 Fr drain. The primary outcome variables were resolution of clinical symptoms such as fever and pain in abdomen, length of hospital stay, and resolution of abscess on imaging at day 3. Secondary outcome was complications related to the procedures. Results Data of 122 patients was collected. Males constituted a vast majority (96%) of the study population and the fifth decade was the most common age group involved. Alcoholics had a higher chance of developing a large ALA. Sixty-eight patients underwent drainage of the ALA using a 24 Fr drain which resulted in faster resolution of symptoms (2.4 vs. 5.1 days, p-value 0.033), a shorter duration of catheter in situ (6.4 vs. 13.2, p-value 0.011), and a faster drainage of ALA (residual volume at day 3; 177 vs. 212 mL, p-value 0.021). Twenty-eight patients had a biliary communication of which 26 required therapeutic endoscopic retrograde cholangiopancreatography. Conclusion In patients with a large ALA, placement of a wide bore 24 Fr catheter hastens recovery of the patients when compared with drainage with a standard 10 Fr pigtail catheter. Placement of a biliary stent serves as a useful adjunct for their management and it may obliviate the need for a major biliary diversion surgery.

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