Percutaneous drainage for giant pyogenic liver abscess—is it safe and sufficient?

Ahmed, Saleem; Chia, C. K.; Junnarkar, Sameer P; Woon, Winston; Shelat, Vishal G

doi:10.1016/j.amjsurg.2015.03.002

Cited by 65 publications

(83 citation statements)

References 36 publications

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“…Although rare, it is potentially life-threatening. Giant LA (>10 cm) is even more uncommon 1. Symptoms and signs are non-specific and the diagnosis relies essentially on imaging with ultrasound (US) and CT scan.…”

Section: Descriptionmentioning

confidence: 99%

“…For pyogenic LA, prompt initiation of empirical broad-spectrum intravenous antibiotics,2 usually a third-generation cephalosporin plus metronidazole, is essential with subsequent adjustment to culture and sensitivity, usually for 10–14 days, depending on clinical and radiological response. Together with CT scan or US-guided percutaneous catheter drainage (PD), it is the initial treatment of choice 1. However, large LA >5 cm predicts failure of PD and the need for surgical drainage 3.…”

Section: Descriptionmentioning

confidence: 99%

“…Malignancy and multiloculation are also risk factors for therapy failure. The best outcome is achieved with close coordination of a multidisciplinary team and rigorous drain management protocol 1. We report the case of a 74-year-old woman with pancreatic carcinoma with liver metastasis that required a biliary prosthesis.…”

Section: Descriptionmentioning

confidence: 99%

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A rare view: giant liver abscess with underlying liver metastases

Matos¹,

Moniz

Dantas

et al. 2017

BMJ Case Reports

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Section: Descriptionmentioning

confidence: 99%

Section: Descriptionmentioning

confidence: 99%

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A rare view: giant liver abscess with underlying liver metastases

Matos¹,

Moniz

Dantas

et al. 2017

BMJ Case Reports

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“…In the majority of patients, PCD is reported to be a safe and sufficient treatment, even for huge PLAs measuring ≥10 cm [15]. In this modern era of minimally invasive PLA management, multilocular poorly liquefied PLA (MPLP) remains a challenge.…”

Section: Introductionmentioning

confidence: 99%

“…According to the previous studies, multilocular abscesses account for about 50% of PLAs [15,19,20]. Half of these multilocular PLAs were difficult to be managed with PCD in our recent experience, and accordingly, MPLPs may account for approximately a quarter of PLAs (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Multilocular Pyogenic Liver Abscess with Poorly Liquefied Content: A Potential Therapeutic Concern

Morii¹,

Yamamoto²,

Nakamura³

et al. 2017

GHOA

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Background: Percutaneous catheter drainage (PCD) is currently the preferred therapeutic procedure of pyogenic liver abscesses (PLAs). However, multilocular poorly liquefied PLAs (MPLPs) are unsuitable for PCD. As reports on MPLPs are scarce, we aimed to explore possible therapeutic strategies for this serious type of PLA. Methods:The medical records of patients with PLA who were hospitalized at our institution between January 2011 to December 2015 were retrospectively reviewed. Demographic factors, biochemical, bacteriological, and imaging results, and treatment outcomes were evaluated.Results: Fourteen patients with MPLPs and 37 with drainable PLAs were identified and included in the study. Clinical characteristics were generally similar between the two groups. Klebsiella pneumoniae accounted for the majority of the culprit pathogens in MPLPs. Patients with MPLPs were managed medically without PCD. Despite this, treatment outcomes were not inferior compared to patients with drainable PLAs. Contrast-enhanced images revealed that the intricate septa of the MPLP maintained its blood perfusion. Most MPLPs did not liquefy over the treatment period. Conclusion:We should remember that MPLP is not rare. The septa may have delivered antibiotics adequately into the MPLPs, thus producing good treatment outcomes. Despite our findings, a high level of suspicion of treatment failure is crucial in these patients to ensure favorable treatment outcomes.

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Liver Abscess: Complications and Treatment

Sharma

Ahuja

2021

Clinical Liver Disease

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Liver abscess is an inflammatory space-occupying lesion of the liver caused by infectious agents. Amoebic liver abscess (ALA) and pyogenic liver abscess (PLA) are its two predominant causes. Rarely, liver abscess can be caused by fungi, mycobacteria, and other atypical organisms. ALA is the predominant cause of liver abscess in India, seen in more than 60% of cases. 1 It is caused by Entamoeba histolytica with feco-oral route, the predominant mode of transmission. In this review, we describe the overview of ALA and PLA, along with its complications and management.

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Percutaneous drainage for giant pyogenic liver abscess—is it safe and sufficient?

Cited by 65 publications

References 36 publications

A rare view: giant liver abscess with underlying liver metastases

A rare view: giant liver abscess with underlying liver metastases

Multilocular Pyogenic Liver Abscess with Poorly Liquefied Content: A Potential Therapeutic Concern

Liver Abscess: Complications and Treatment

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