Clinicopathological study and management of liver abscess in a tertiary care center

Abstract

Background:Liver abscess is a burning problem in tropical nations, with often lethal consequences and diagnostic/therapeutic challenges. We have determined etiopathology, clinical, radiological, and bacteriological characteristics of this condition and review its management strategies.Materials and Methods:During the period of the month from May 2007 to September 2009, a prospective study was performed involving 125 patients admitted to the in-patient ward of the Department of General Surgery of N.R.S Medical College their diagnosis was made on the basis of clinical features (such as right upper abdomen pain, and fever), laboratory investigations and radiological evidence of liver abscess.Results:Amoebic liver abscess was the most common (88%) type of liver abscess among the study groups. There was a strong correlation with the occurrence of liver abscesses and addiction to alcohol, history of diabetes mellitus and low socioeconomic status. The most common etiology of pyogenic liver abscess was Escherichia coli. Ultrasonography (USG) of the abdomen was accurate and cost-effective in diagnosis of liver abscesses. Percutaneous catheter drainage was the most effective method of treatment (with a 100% success rate).Conclusion:Most patients in our study had liver abscess of amoebic origin and had temporal relationship with diabetes, alcoholism, and staggering socioeconomic status. We suggest early recognition of clinical features and prompt abdominal USG as cost-effective means for treatment initiation and reducing complications.

A Case Report: Ruptured of Pyogenic Liver Abscess

“…(Khosravani et al, 2017) Laboratory findings obtained include leukocytosis, eosinophilia, increased erythrocyte sedimentation rate (ESR), HB <10 mg%, bilirubin >1 mg/dl, increased alkaline phosphatase, increased serum glutamic oxaloacetic transaminase, increased serum glutamic pyruvic transaminase, abnormal prothrombin time (PTT) and hypoalbuminemia. (Jha et al, 2015) In our patient, showed leukocytosis, eosinophilia, increased liver function, abnormal coagulation test and hypoalbuminemia. These results are more directed to the infection process than to malignancy.…”

Hepatic Infections: A Comprehensive Imaging Review

“…In the developed countries, pyogenic abscesses are more common, while in the developing and underdeveloped regions, amebic abscesses form the majority. 1,2 Abscesses involve the right lobe in about two-third of cases, probably in accordance with the proportion of portal blood received by the right lobe. Up to a fifth of the patients may have multiple abscesses.…”

“…Amebic liver abscess is commonly seen in the 3rd and 4th decades, with a striking male preponderance (M:F ratio 4-10:1). 1,4,5 Most cases either reside in or have a history of recent travel to a tropical, endemic region. The imaging findings of amebic abscess have been discussed later.…”

Diabetes and obesity and risk of pyogenic liver abscess

“…There were reports of chewing betel-nut (Areca catechu) increasing the risk of liver cirrhosis and liver cancer, which may then increase the risk of liver abscess 49 . And poor economic status was associated with increasing risk of pyogenic liver abscess in an India study 50 .…”