Published: 2018-03-23

What is the recent trend in the clinical study of liver abcess cases?

Nandhkishore Narwade, Abhijit Bagul, Naseem Khan, Sridevi Murali, Rahul Borude, Aniket Ray, Yashraj Shah


Background: Liver abscesses commonly occur secondary to biliary or intestinal tract infections, haematogenous seeding or extension of contiguous infection, and carry a mortality rate of 20-60% even with appropriate medical-surgical management. The aims of the study were to study the current prevelence of etiological factors in cases of liver abscess, to study clinical presentations in cases of liver abscess and study outcomes of the current trend in investigations and outcomes of the modes of treatment in cases of liver abscess.

Methods: 50 patients with the diagnosis of liver abscess belonging to various age groups and socio-economic status are included in the study. Written consent and a pre designed proforma was taken from all the patients and to collect relevant data form the patients included in the study.

Results: In our study of 50 cases of liver abscess age ranges from 16 to 65, with majority of patients being in young age group (14-34 years). The median age for our study of liver abscess is 31. In our study, there were number of males 41 (82%) greater than females 9 (18%). In our study, right hypochondrium pain 12 cases (24%) was the most common presenting symptom among all liver abscess.

Conclusions: Percutaneous aspiration along with medical management yields far better results. Ultrasonography is the most important recommended tool for the initial diagnostic investigation in liver abscess cases with percutaneous aspiration and pigtailing. Hence the prognosis of liver abscess has been improved with different advanced modalities in the management of liver abscess with less or no mortality except in patients with malignant disease.


Amoebic liver abscess, Pyogenic liver abscess, Per cutaneous aspiration, Pig Tailing

Full Text:



Branum GD, Tyson GS, Branum MA. Hepatic abscess: Changes in etiology, diagnosis and management. Ann Surg. 1990;212:655-62.

Mohsen AH, Green ST, Read RC et al Liver abscess in adults: Ten years' experience in a UK centre. Q J Med. 2002; 95:797-802.

Johannsen EC, Sifri CD, Madoff LC. Pyogenic liver abscesses. Infect Dis Clin North Am. 2000;14:547-63.

Chou FF, Sheen-Chen SM, Chen YS, Chen MC.. Single and multiple pyogenic liver abscesses: Clinical course, etiology, and results of treatment. World J Surg. 1997;21:384-8.

Chu KM, Fan ST, Lai EC, Lo CM, Wong J. Pyogenic liver abscess: An audit of experience over the past decade. Arch Surg. 1996;131:148-52.

Civardi G, Filice C, Caremani M, Giorgio A. Hepatic abscesses in immunocompromised patients: Ultrasonically guided percutaneous drainage. Gastrointest Radiol. 1992;175:17-23.

Alvarez Perez JA, Gonzalez JJ, Baldonedo RF et al, Clinical course, treatment, and multivariate analysis of risk factors for pyogenic liver abscess. Am J Surg. 2001;181(2):177-86.

Walsh JA. Problems in recognition and diagnosis of amebiasis: Estimation of the global magnitude of morbidity and mortality. Rev Infect Dis. 1986;8:228-38.

Wong WM, Wong BC, Hui CK et al, Pyogenic liver abscess: Retrospective analysis of 80 cases over a 10-year period. J Gastroenterol Hepatol. 2002;17:1001-7.

Seeto RK, Rocky DC. Pyogenic liver abscess: Changes in etiology, management, and outcome. Medicine. 1996;75:99-113.

Sabbaj J, Sutter VL, Finegold SM: Anaerobic pyogenic liver abscess. Ann Intern Med. 1972;77:627-38.

Chemaly RF, Hall GS, Keys TF, Procop GW. Microbiology of liver abscesses and the predictive value of abscess gram stain and associated blood cultures. Diagn Microbiol Infect Dis. 2003;46:245-8.

Bangaroo AK, Malhotra AS: Isolated hepatic tuberculosis. J Ind Assoc Paediatr Surg 2005;10(2):105-7.

Conter RL, Pitt HA, Tompkins RK, Longmire WP Jr. Differentiation of pyogenic from amebic hepatic abscesses. Surg Gynecol Obstet. 1986;162:114-20.

Lodhi S, Sarwari AR, Muzammil M, Salam A, Smego RA. Features distinguishing amoebic from pyogenic liver abscess: A review of 577 adult cases. Trop Med Int Health. 2004;9:718-23.

Petri WA Jr, Singh U. Diagnosis and management of amebiasis. Clin Infect Dis. 1999;29:1117–25.

Perera MR, Kirk A, Noone P. Presentation, diagnosis and management of liver abscess. Lancet. 1980;2:629-32.

Johnson RD, Muller PR, Ferrucci JT et al, Percutaneous drainage of pyogenic liver abscess. Am J Roentgenol. 1985;144:463-7.

Rintoul R, O'Riordan MG, Laurenson IF, Crosbie JL, Allan PL, Garden OJ. Changing management of liver abscess. Br J Surg. 1996;83:1215-8.

Neoptolemos JP, Macpherson DS, Holm J, Fossard DP. Pyogenic liver abscess: a study of forty‐four cases in two centres. Acta Chir Scand. 1982;148:415-21.

Herbert DA, Fogel DA, Rothman J et al, Pyogenic liver abscesses: successful non‐surgical therapy. Lancet. 1982;1:134-6.

Ochsner A. Pyogenic abscess of the liver. Am J Surg. 1938;40:292.

Acuna-Soto R, Maguire JH, Wirth DF. Gender distribution in asymptomatic and invasive amebiasis. Am J Gastroenterol. 2000;95(5):1277-83.

Marc SJ, Patterson M. Amebic liver abscess: 1966- 1976. Am J Digest Dis. 1978;23(2):110-8.

Ralls PW, Barnes PF, Johnson MB, De Cock KM, Randall RD, Halls J. Medical treatment of hepatic amebic abscess: rare need for percutaneous drainage. Radiology. 1987;165:805-7.

Satiani B, Davidson ED. Hepatic abscesses: improvement in morality with early diagnosis and treatment. Am J Surg. 1978;135:647-50.

Shah N, Gupta VB, Kapoor M, Quari H, Altaf A, Para M. Liver abscess in the tropics: an experience from Jammu. Scottish Med J. 2014;59(3):167-71.

McGarr PL, Madiba TE, Thomson SR, Corr P. Amoebic liver abscess: results of a conservative management policy. South African Med J. 2003;93(2):32-6.

Rahimian J, Wilson T, Oram V, Holzman RS. Pyogenic liver abscess: recent trends in etiology and mortality. Clin Infect Dis. 2004;39:1654.

Livraghi T, Giorgio A, Marin G, Salmi A, De Sio I, Bolondi L, Torzilli G. Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection. Radiology, 1995;197(1):101-8.

Bertel CK, van Heerden JA, Sheedy PF. Treatment of pyogenic hepatic abscesses: surgical vs percutaneous drainage. Arch Surg. 1986;121(5):554-8.