Image Guided Management of Various Liver Abcess

Abstract

Background: Amoebic liver abscess is an important cause of inflammatory space occupying lesion of liver in the tropics. The primary aim of our study is to study the clinical presentations, investigations, diagnosis and management of amoebic liver abscess. Methods: All patients diagnosed with liver abscess in Hi-Tech Medical and hospital, Bhubaneswar, Odisha, over a period of two years from September 2014 to September 2016. After obtaining clearance and approval from the institutional ethical committee, detailed history of all patients is taken with thorough clinical examination; required Investigations were done and entered into a proforma during their stay and follow up. Therapeutic aspiration reserved for the following cases where: Size of abscess is more than 5 cm in diameter (125ml). When pain and fever persist for more than 3 to 5 days after starting Antiamoebic therapy. Four clinical variables-abdominal pain, fever, anorexia, and hepatomegaly-were assessed on daily basis. Finally, The patients were asked to visit for reassessment once a month for 3 months. Results: A total of 30 patients of amoebic liver abscess were included and studied during the time period. Out of 30 patients of liver abscess, 14 patients gave history of alcohol consumption, comprising 47% of the study population. than 5 cms were treated conservatively. In Patients treated by percutaneous aspiration, 12 were having cavities ranging 11-25 cms and 5 with cavities ranging 6-10 cms. 60% of patients were treated by ultrasound guided percutaneous aspiration and 40% of patients were treated by conservative management. Conclusion: Ultrasonography helps in early diagnosis and reducing morbidity and mortality. It also confirms the site, size and number of amoebic liver abscess and knowing the prognosis.