Clinical study of liver abscess

Abstract

Background: Liver abscesses, both amoebic and pyogenic, is an important cause of morbidity and mortality in tropical countries. However, liver abscess have been managed by conservative, percutaneous needle aspiration, surgical drainage and endoscopic drainage. The aim of our study was to study the etiological, predisposing factors, signs and symptoms and various modalities of treatment of liver abscess.Methods: In this study 30 cases of liver abscess, required data was collected and was compared statistically. All cases were studied upto discharge regarding presenting signs and symptoms and treatment modalities.Results: Liver abscesses were more common in males. History of alcoholism was present in 60% of cases. The common clinical features were rt hypochondriac tenderness 100%, tender hepatomegaly 90%, fever 97%, anorexia 77%, weight loss 40%, jaundice 13%. Elevated leukocytes was seen in 72%, elevated serum bilirubin in 17%, serum alkaline phosphatase in 50 % and serum transaminase in 17% of cases. Right lobe of liver was involved in 87%, left lobe in 13%, both lobes in 0%. 23% of cases were treated conservatively, 50% by aspiration, 27% by surgical open method drainage, complications were secondary infection in 8%, rupture into peritoneal cavity 13% and pleural effusion 17%. Mortality was nil.Conclusions: The modern day ultrasound and other non-invasive imaging techniques had greatly revolutionized the diagnosis and management of the liver abscess. Conservative management with IV antibiotics and USG guided percutaneous aspiration of liver abscess are most frequent treatment modalities used now, with fewer complications.