Abscesses of the Liver: Surgical Considerations

Pyogenic liver abscess

“…Accuracy for amebic abscesses has been reported to be as high as 98% [45,46]. Similarly, reduction in mortality rate from 83% to 23% has been attributed to the earlier diagnosis afforded by scanning techniques [16]. An increase in the rate of antemortem diagnosis from 19% to 78% has been reported with the increasing utilization of hepatic scintiscans.…”

Microflora of the Biliary Tree and Liver – Clinical Correlates

“…173] and to some extent enterobacteria are responsible patho gens [171,174], Chronic granulomatous dis ease and malignancy are underlying diesascs leading to an immune deficient state [173].…”

Non-parasitic liver abscess

“…The size of the abscess is the important criterion according to Altmeier et al (1970), who divided hepatic abscesses into those greater and those less than 1.5cm in diameter o n the basis that those more than 1.5 cm can be drained (and presumably diagnosed). Based on the present series there seem to be three types of liver abscess:…”

“…The ratio was less than unity in all 11 instances, in only one of which was the serum albumin level greater than 3 g per cent. The importance of a low serum albumin has been previously stressed (Butler and McCarthy, 1969;Altmeier et al, 1970;Lazarchick et al, 1973), but the value of the serum protein ratio has not previously been emphasized.…”

“…Most authors stress the dire results of omitting surgical exploration of suspected hepatic abscess and most anticipate 100 per cent mortality (Grant et al, 1969;Altmeier et al, 1970). Joseph et al (1968) reported a mortality of 4 out of 36 in cases which were drained compared with 30 out of 35 in those not drained; in a further American report, mortality was 38 per cent when the abscess was drained but 90 per cent when no drainage was undertaken (Brodine and Schwartz, 1973).…”