Pyogenic liver abscess: An audit of 10 years’ experience

Pang, Tony; Fung, Thomas; Samra, Jaswinder S.; Hugh, Thomas J.; Smith, Ross C.

doi:10.3748/wjg.v17.i12.1622

Cited by 157 publications

(130 citation statements)

References 18 publications

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“…7-9 However, Pang et al and Heneghan et al reported it to be 2:1 and 1.22:1, respectively. [10][11][12] In present study, alcohol was found to be a major risk factor as 48% cases were alcoholic. Ghosh et al had 72% alcoholic patients in their study.…”

Section: Discussionsupporting

confidence: 47%

Correlation between abscess size and liver function tests in cases of liver abscess

Jain¹,

Manjavkar²,

Rajput³

et al. 2017

Int J Res Med Sci

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Background: Liver abscess has shown a major change in demographics, etiology, diagnosis, and treatment over the past 100 years. The modern diagnostics like ultrasound and computed tomography to locate and drain the abscess have reduced the mortality to 2-12%. However, due to the complications of liver abscess especially the amebic ones the morbidity is still high. This study aims to study the correlation of various LFT parameters with abscess volume for early detection of high risk patients and early treatment thus reducing morbidity.Methods: The study was conducted over a period of 6 months on 50 patients of liver abscess. History and physical examination was done. All patients were subjected to complete hemogram, liver function test, coagulation profile (PT/INR) and USG abdomen. The data was recorded and compiled in excel sheets and analyzed using correlation coefficient (R) method.Results: The mean age of the patients was 41.2 years with male preponderance. Amoebic liver abscess (88%) was predominant over pyogenic liver abscess (12%). Alcoholism (48%), smoking (42%) and diabetes mellitus (18%) are main predisposing factors in case of liver abscess. Hepatomegaly was found in 88% cases. Elevated ALP, low albumin, increased PT INR points to the diagnosis of liver abscess. Complications seen were pleural effusion (10%) and ascites (4%). On analysis, liver abscess size is significantly positively correlated with INR, ALP, liver enzymes, and negatively correlated with serum albumin level.Conclusions: Liver abscess size was found to be positively correlated with INR and alkaline phosphatase (ALP), liver enzymes (SGOT, SGPT) and negatively correlated with serum albumin levels. There was no correlation of abscess size and bilirubin levels. Hence, LFT can be used to estimate the liver abscess size and predict the severity and prognosis of patient.

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Section: Discussionsupporting

confidence: 47%

Correlation between abscess size and liver function tests in cases of liver abscess

Jain¹,

Manjavkar²,

Rajput³

et al. 2017

Int J Res Med Sci

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“…12,13 In present study alcohol consumption was seen as a major risk factor as 58.4% patients of ALA were exposed to it, however only 14.2% of PLA cases were found alcoholic. It is contrary to the study of Islam QT et al which showed that indigenous alcohol has association with the development of pyogenic liver abscess.…”

mentioning

confidence: 47%

“…However, studies from west where PLA are more common, average age is above 60years. [12][13][14] As far as sex predisposition was concerned, after recruiting 50 consecutive patients, only 9 patients were female. Indian data show predominant male involvement; Sharma et al, Mukhopadhyay et al and Ghosh et al, reported male to female ratio to be 14.4:1, 7:1 and 11:1, respectively.…”

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confidence: 99%

Clinical and biochemical profile of liver abscess patients

et al. 2017

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Background: Liver comprises 48% of all the visceral abscesses. It is common in India with 2nd highest incidence due to poor sanitation, overcrowding and inadequate nutrition. Worldwide, approximately 40-50 million people are infected annually with amoebic abscesses. This study aims to observe the clinical and biochemical profile of liver abscess patients so that a prompt diagnosis can be made and early treatment can be given.Methods: The study was conducted over a period of 1 year on 50 patients of liver abscess. History and physical examination was done. All patients were subjected to complete hemogram, liver function test, coagulation profile (PT/INR) and USG abdomen. Serology for Entamoeba histolytica and HIV was done.Results: The mean age of the patients was 41.8 years with male preponderance. Amoebic liver abscess (86%) was predominant over pyogenic liver abscess (14%). Alcoholism (52%) and diabetes mellitus (20%) are main predisposing factors in case of liver abscess. Hepatomegaly was found in 80% cases. Elevated ALP, low albumin, increased PT INR points to the diagnosis of liver abscess. The abscesses were predominantly in right lobe (76%) and solitary (66%). Complications seen were ascites (12%) and pleural effusion (6%).Conclusions: Liver abscess should be suspected in patients presenting with prolonged fever and pain upper abdomen specially if patient is alcoholic or has diabetes mellitus. Ultrasonography is an easy and cost effective investigation to diagnose liver abscess. Early and aggressive treatment is the mainstay to prevent complications, morbidity and mortality.

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“…Computed tomography (CT) abdomen showed multiple hypodense lesions in the The causative organism cannot be isolated in 21% of patients. 9 Pus, blood and pleural fluid cultures did not reveal any organism in our patient. Abscesses due to biliary sepsis, presence of shock, multiple abscesses are independent predictors of mortality.…”

Section: Discussionmentioning

confidence: 49%

“…Imaging guided needle aspiration was favoured over catheter drainage at our institution .Some groups prefer needle aspiration over catheter drainage, and some prefer catheter drainage over needle aspiration. 9 Multiple liver abscess have been rarely reported in world literature. Bahloul et al have reported a fatal case of multiple liver abscess in a 38 yr old woman which required surgical drainage.…”

Section: Discussionmentioning

confidence: 99%

Multiple Pyogenic Liver Abscess

et al. 2013

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Multiple liver abscess is a life threatening condition with high mortality. We present a case of a 59 yr old gentleman who developed multiple hepatic abscesses due to an appendicular mass. He was treated with parenteral antibiotics and ultrasound guided needle aspiration of the largest abscess was done. He recovered promptly with complete resolution of the liver abscesses. The main aim of this case report is to highlight the fact that multiple pyogenic liver abscesses can be managed with antibiotic treatment and needle aspiration.

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Pyogenic liver abscess: An audit of 10 years’ experience

Abstract: PLA is a diagnostic challenge, because the presentation of this condition is non-specific. Intravenous antibiotics and radiological drainage in the first instance allows resolution of most PLAs; However, a small proportion of patients still require surgical drainage.

Cited by 157 publications

References 18 publications

Correlation between abscess size and liver function tests in cases of liver abscess

Correlation between abscess size and liver function tests in cases of liver abscess

Clinical and biochemical profile of liver abscess patients

Multiple Pyogenic Liver Abscess

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