Pyogenic Hepatic Abscess

Huang, Chih‐Cheng; Pitt, Henry A.; Lipsett, Pamela A.; Osterman, Floyd A.; Lillemoe, Keith D.; Cameron, John L.; Zuidema, George D.

doi:10.1097/00000658-199605000-00016

Cited by 478 publications

(201 citation statements)

References 15 publications

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“…Our data are in agreement with reports [2, 8, 12]that show an increasing incidence of biliary tract-related disorders as the predominant source of liver abscess. Few papers have mentioned the etiologic differences between single and multiple abscesses.…”

Section: Discussionsupporting

confidence: 93%

“…By contrast, over the last 6 years, only 24 of 86 patients (27.9%) have undergone operation as the primary method of treatment. Multiple abscesses have been reported to carry a higher mortality rate [2, 10, 11, 21]. The present study tends to support the finding of a higher mortality rate for multiple abscesses.…”

Section: Discussionsupporting

confidence: 81%

“…A fatal outcome in cases with multiple abscesses was only seen in patients not so seriously ill (low APACHE II score); however in severely ill patients (high APACHE II score) this fact was not confirmed. Neither in single nor in multiple abscesses did the presence of associated malignancy appear as a risk factor, as reported in earlier studies [2, 8]. …”

Section: Discussionmentioning

confidence: 55%

“…Thus the advent of modern diagnostic imaging techniques allowed a precise localization of the abscess and the development of image-guided percutaneous aspiration and drainage of abscess reduced mortality to more acceptable levels. However, mortality rates of 10–40% continue to be reported [2, 3, 4, 5, 6]. …”

Section: Introductionmentioning

confidence: 99%

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Single and Multiple Pyogenic Liver Abscesses: Etiology, Clinical Course, and Outcome

et al. 2001

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Background: Pyogenic liver abscesses are uncommon but they still carry a high mortality rate when encountered. This study was undertaken to evaluate the differences in the clinical behaviour of patients with single and multiple abscesses. Methods: From January 1985 to December 1997, 133 patients with this disease were treated in the surgical departments of five hospitals, 97 had a single abscess and 36 had multiple abscesses. Clinical features, methods of treatment, and outcome were assessed and compared in both types of abscesses. Results: A biliary origin from ascending cholangitis was most frequently found in multiple abscesses (p = 0.007). Mean age and duration of symptoms were higher in multiple lesions (p = 0.03 and p = 0.001). High levels of alkaline phosphatase were more frequently seen in multiple abscesses than in solitary ones (p = 0.02). They were both most frequently located on the right side. Antibiotic therapy alone was most frequently used in multiple abscesses (p = 0.01). Mortality rate was also higher in this type of patients (p = 0.01). The abscess-related morbidity rate was higher in multiple lesions as well but the statistical difference was not significant. Conclusions: These results suggest that multiple liver abscesses comprise a disease of biliary origin, higher age, longer symptomatic periods, and also higher mortality rate than in single abscess.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Single and Multiple Pyogenic Liver Abscesses: Etiology, Clinical Course, and Outcome

et al. 2001

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“…It is still, however, a life-threatening disease. The reported mortality rate ranged from 8 to 31% in the 1990s [4, 5, 6]despite improvements in diagnosis and treatment. Image-guided percutaneous drainage offers a low-risk approach to often critically ill patients and achieves effective drainage without the need of general anesthesia and surgery [7].…”

Section: Introductionmentioning

confidence: 99%

Pyogenic Liver Abscess: An Audit of 10 Years’ Experience and Analysis of Risk Factors / with Invited Commentary

Lee

Wong

Sheen³

2001

Dig Surg

157

106

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Background/Aims: Despite continuous improvement in image modalities, availability of potent antibiotics and advancement in the knowledge and treatment of pyogenic liver abscess, mortality remains high. The high mortality rate has underlined the important role of prognostic factors and prompts a number of studies to identify the risk factors. The present study aims to audit our experience in managing patients with pyogenic hepatic abscess during the period of 1989–1999, and to document changes in etiology, bacteriology and outcome, and to identify any risk factor associated with mortality. Methods: One hundred and thirty-three patients with pyogenic hepatic abscess were studied to determine the demographic characteristics, clinical features, laboratory, bacteriological findings, methods of treatment, final outcome and risk factor analysis. All patients were treated with parenteral antibiotics. One hundred and twelve patients were subjected to ultrasound-guided percutaneous aspiration of the abscess. A percutaneous drainage catheter was inserted after aspiration in all patients. Laparotomy was done in 21 patients. Results: The overall hospital mortality rate was 6% (8/133). Biliary tract disease was the most frequently identified cause. Leukocytosis, hypoalbuminemia and hyperbilirubinemia were common laboratory findings. The most common microorganism cultured was Klebsiella pneumoniae. The most common concomitant disease was diabetes mellitus. On univariate analysis, large abscess, diabetes mellitus and sepsis were significantly associated with hospital mortality. On multivariate logistic regression analysis, the presence of sepsis (p = 0.0031) was found to be an independent risk factor. Conclusions: In addition to early diagnosis and prompt treatment, making every effort to treat patients with adverse prognostic factors and systemic complications, the hospital mortality rate will be decreased significantly.

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Pyogenic Liver Abscesses in Patients With Malignant Disease

et al. 1998

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Background: Prognosis of pyogenic liver abscesses in patients with malignant disease is generally considered poor. The discrepancy between the outcomes of liver abscesses caused by hepatopancreatobiliary malignant disease and those caused by other malignant diseases, however, to our knowledge has never been investigated. Objectives: To clarify the clinical course of pyogenic liver abscess in patients with different types of cancer, and to compare outcomes in abscesses caused by hepatopancreatobiliary malignant disease and other malignant disease. Design: Retrospective review of case series in our experience from 1980 through 1993. Setting: Tertiary care university teaching hospital. Patients: Fifty-two patients with pyogenic liver abscess related to the underlying cancer were divided into 2 groups. Group 1 (n=32) was composed of patients with cancer originating from the hepatic parenchyma, bile duct, and pancreas; group 2 (n=20) was composed of patients with cancer originating from other sites.

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Pyogenic Hepatic Abscess

Cited by 478 publications

References 15 publications

Single and Multiple Pyogenic Liver Abscesses: Etiology, Clinical Course, and Outcome

Single and Multiple Pyogenic Liver Abscesses: Etiology, Clinical Course, and Outcome

Pyogenic Liver Abscess: An Audit of 10 Years’ Experience and Analysis of Risk Factors / with Invited Commentary

Pyogenic Liver Abscesses in Patients With Malignant Disease

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