Clinical, laboratory and management profile in patients of liver abscess in central India

Abstract

Background:Abscess of the liver has been recognized since the time of Hippocrates. Even today, it remains a surgical problem with considerable morbidity and mortality. Advances in diagnostic and interventional radiology over the last three decades have facilitated a minimally invasive approach to management of this condition. We have reviewed our experience in managing liver abscess over the last 2 years, to illustrate the current etiology, management and outcomes of this disease. We also reviewed the literatures in this field, and present a summary of current practice patterns which may serve as a useful guide, thereby, defining optimum management of the Liver abscess and assessing new trends in treatment.

Methods: Patients were selected from Hospital attached to Sri Aurobindo Medical College and Post graduate Institute, Indore, MP, India. Study was conducted during the period from December 2012 to September 2014. 160 patients of liver abscess were included in the study. All patients in our study were subjected to detailed history taking, clinical examination, routine investigations and various specialized investigations.

Results:Amoebic liver abscess was the most common (53.12%) type; most liver abscess among the study group had strong correlation with alcoholism, poor hygiene and low socioeconomic status. Percutaneous catheter drainage under Ultrasonography guidance was the most effective method of treatment.

Conclusions:Early recognition of septicaemia or organ failure and appropriate transfer to critical care unit. Consider repeat imaging to confirm correct drain placement and to determine response to treatment and final resolution of the abscess. Open surgical or laparoscopic intervention should be considered for patients with large, complex, spectated or multiple abscesses, underlying disease or in whom percutaneous drainage has failed.