Our experiences with liver abscesses in hospitals attached to Bangalore Medical College and Research Institute, India

Abstract

Background: Liver abscess is a common problem in India and is associated with high morbidity and mortality. Broadly they can be divided into two types- Pyogenic and Amoebic. Amoebic in particular has a very high burden on society in India, believed to be secondary to poor sanitation and hygiene in the population.Methods: We performed a prospective, descriptive case series assessing demographic characteristics, presentation patterns, etiological factors, microbiological etiology, and management for patients treated for liver abscess at our centres between 2016 and 2018. 70 patients were identified and diagnosed on the basis of ultrasound and gram staining and culture of the pus aspirate.Results: Amoebic liver abscess was in majority (75%), with males being more affected than females (90%). Alcoholic and diabetic males between 30 and 50 years of age were most affected. Most presented with abdominal pain (96%). 53% needed Pigtail catheter drainage. Average duration of stay was 8 days, and 72% of the total patients showed relief of symptoms within 3 days.Conclusions: Most cases were found to be due to amoebic etiology rather than pyogenic. Both amoebic and pyogenic abscesses are noted to be more common in young men between the ages of 20 - 50, with a higher incidence noted among the alcoholic and diabetic patients. Most patients present with Upper abdominal pain and ultrasound is a useful tool in diagnosing the condition and providing valuable information about the site and volume of the abscess. Majority of patients needed Ultrasound guided drainage of the abscess. Average hospital stay was 8 days.