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Background: With the advances in the intervention radiological techniques the laparotomy for liver abscess has been taken over by the percutaneous ultrasound guided needle aspiration as well as percutaneous ultrasound guided pigtail catheter drainage. This study was undertaken at Govt. Medical College & Associated hospitals, Jammu to assess the outcome of this minimally invasive procedure for Liver abscess. Methods: 126 patients were subjected to pigtail catheter drainage after localization with ultrasonography using modified Seldinger's technique. The pigtail catheters of 8-14 Fr size was were used. All the samples of pus were subjected to microscopy for EH trophozoites, Gram stain and for pus culture and sensitivity. Patient's vitals were monitored for 24 hours. Daily estimation of volume, colour and consistency of the drainage fluid was recorded. Follow-up USG was done on average of 5th postoperative day to assess the shrinkage of cavity and the amount of residual fluid. Removal of catheter was decided based on; the amount of pus drained (<50 ml for three consecutive days); disappearance of symptoms & signs; and USG abdomen showing signs of resolution. Results: The age of the patients in this study ranged from the 21 years to 70 years with M: F ratio of 13.5: 1. Pain, fever, tender hepatomegaly & anaemia were common symptomatology. Right lobe abscess was seen in 74.60% (n=94) of patients. Solitary abscess was seen in 110 patients (87.3%). 66 patients (52.38%) had ALA, 18 patients PLA & 42 were having indeterminate liver abscess. Smaller size catheter specially 8-10 Fr invariably blocks. Common problems encountered were local pain or discomfort due to catheter, peri-tubal leak in few cases, and local wound infection. The average period of continuous catheter drainage was 7.2 days maximum being 26 days. Average duration of hospital stay was 2.45 days. Success rate of the procedure was 96.82% (n=122). 04 patients needed laparotomy. Conclusions: Advances in interventional radiology have influenced management of liver abscess. We in our series of 126 pts of liver abscess conclude that image guided percutaneous pigtail drainage of liver abscess is a safe, effective minimally invasive procedure with negligible morbidity and no mortality. High procedural success rate has almost replaced conventional laparotomy in uncomplicated liver abscess.

Abstract:Context: Injury has been a constant companion of mankind since the times immemorial. Although the modern trauma care has scaled new heights vis-a vis the infrastructure and the technical expertise, trauma remains defiant and continues to pose a huge challenge to the modern society in view of ever increasing magnitude. Material and methods: A series of 100 patients admitted with blunt trauma abdomen over a period of one year in Government Medical College, Jammu was enrolled in the study design. Result-Abdominal trauma usually affects the younger generation, in particular the male gender. Majority of the patients were victims of road traffic accidents. The overall mortality from blunt trauma abdomen was 11%. Conclusion:No age is exempted from abdominal trauma but a high index of suspicion, early diagnosis and requisite management are very important for a favorable outcome.

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