Hepatic abscess: Changes in clinical, bacteriologic and therapeutic aspects

Rubin, Robert H.; Swartz, Morton N.; Malt, Ronald A.

doi:10.1016/0002-9343(74)90012-6

Cited by 184 publications

(93 citation statements)

References 56 publications

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“…The patients were then put on the appropriate oral antibiotics for a total treatment period of 4 weeks. 9 A sample of pus was routinely taken and sent for microbiological analysis including microscopy, culture, and antibiotic sensitivity tests.…”

Section: Antibiotics Policymentioning

confidence: 99%

Liver abscess drainage by needle aspiration versus pigtail catheter: a prospective study

Khan

Tekam

2017

Int Surg J

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Background: Liver abscess is a disease of frequent occurrence which figures prominently in the differential diagnosis of upper abdominal and right lower respiratory tract diseases. These includes a recent increase in incidence reflecting more accurate diagnostic techniques especially after 1965 with the advent of radioisotopes scan and later on ultrasonography and CT scan. The reduction in mortality from 90% at the turn of century to the estimated 10-20% today cannot be ascribed to surgery alone.Methods: The study was conducted on 65 patients of liver abscess. Two compared modalities of percutaneous treatment of liver abscess were (1) needle aspiration and (2) pigtail catheter aspiration. All interventions were performed under ultrasonographic guidance. Only those patients having liver abscess/abscesses greater than 5 cm in at least one dimension, liquified & drainable were included in this study.Results: Amoebic liver abscess (63.33%) were more common than pyogenic liver abscess (26.67%). Clinical recovery was significantly earlier in catheter group (average 5 days) than in needle aspiration group (average 6.29 days) (p value 0.001). Average duration of i.v. antibiotic is significantly shorter in catheter group (6.4 days) than in needle aspiration group (9.5 days) (p value 0.002).Conclusions: Thus, our study concluded that in view of greater volume of pus drained in first sitting, early clinical recovery, shorter duration of hospital stay and slightly more success rate continuous catheter drainage is effective percutaneous treatment modality than intermittent needle aspiration.

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Section: Antibiotics Policymentioning

confidence: 99%

Liver abscess drainage by needle aspiration versus pigtail catheter: a prospective study

Khan

Tekam

2017

Int Surg J

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“…The incidence of pyogenic liver abscess has remained relatively constant during this century (16). The major organisms causing pyogenic liver abscess are aerobic Gram-negative Enterobacteriaceae, including Escherichia coli, Klebsiella pneumoniae, and anaerobic bacteria, especially Bacteroides fragilis (9).…”

mentioning

confidence: 99%

Role of T Lymphocytes in Liver Abscess Formation by Bacteroides fragilis in Mice

Chung¹,

Park²,

Park³

et al. 2011

Infect Immun

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The underlying mechanisms of liver abscess formation have not been fully elucidated with regard to the interaction between bacterial virulence factors and the immune response. The objective of this study was to determine the role of the host T cells in liver abscess formation caused by Bacteroides fragilis. We developed a liver abscess mouse model with inoculation of B. fragilis through the hepatic portal vein and examined the role of T cells by studying T cell-deficient mice, as well as conducting adoptive T cell transfer experiments. No microabscess was formed in the ␣␤ T cell receptor-positive (␣␤TCR ؉ ) T cell-depleted mice, in contrast to the results for the control mice. In addition, the ␣␤TCR knockout (KO) mice showed significantly lower numbers of microabscesses, and the abscesses were smaller in size than those in the wild-type mice. Adoptive transfer of T cells purified from the wild-type mice into the ␣␤TCR KO mice resulted in liver abscess formation in those mice. These findings suggest that T cells play an essential role in liver abscess formation caused by B. fragilis in mice.

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“…Few series in the literature have experienced similar problem with the small bore pigtail catheters. [34][35][36][37][38] We recommend that 12-14 F pigtail catheters are adequate size to be used for the procedure. The overall success rate of the procedure was 94%.…”

Section: Discussionmentioning

confidence: 99%

Outcome of ultrasound guided pigtail catheter drainage of liver abscesses a prospective study of 126 cases

2015

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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.

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Hepatic abscess: Changes in clinical, bacteriologic and therapeutic aspects

Cited by 184 publications

References 56 publications

Liver abscess drainage by needle aspiration versus pigtail catheter: a prospective study

Liver abscess drainage by needle aspiration versus pigtail catheter: a prospective study

Role of T Lymphocytes in Liver Abscess Formation by Bacteroides fragilis in Mice

Outcome of ultrasound guided pigtail catheter drainage of liver abscesses a prospective study of 126 cases

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