Liver abscess: An observational study of clinical presentation and its management

Abstract

Liver abscesses, both amoebic and pyogenic, continue to be an important cause of morbidity and mortality in tropical countries. However, different modalities of treatment of liver abscess are conservative (medical management), percutaneous needle aspiration, percutaneous catheter drainage, surgical drainage and endoscopic drainage. The aim of the study is to evaluate the clinical presentation and the different management done for liver abscess. This is an observational prospective study for presentation of liver abscess and its management done in the department of general surgery, simmer hospital, Surat, Gujarat, India from 1 st January 2018 to 31 st December 2018. In this study, 35patients (23 males and 12 females; age range, 2-72 years; average age, 35 years) with liver abscesses (amebic 08; pyogenic 27) underwent either percutaneous needle aspiration, percutaneous catheter drainage, or surgical intervention along with appropriate antimicrobial therapy. In patients assigned to the needle aspiration group, an 18-gauge spinal needle under local anaesthesia was used to aspirate the abscess cavity. For catheter drainage, 8-to 12-French catheters were introduced into the abscess cavity using the Seldinger technique. Patients were followed up to assess the outcome of the treatment, length of hospital stay, and development of any complications. Sonography was performed every third day during hospitalization in cases of percutaneous needle aspiration and percutaneous catheter drainage. After discharge of the patient, periodic clinical and sonographic examinations were done until total resolution of abscesses was achieved. Improvement in clinical features, liver function tests, ultrasonic evidence of decrease in the size of abscess cavity was considered as criteria for successful treatment.