Original article / research
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Year :2021
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Month :
January
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Volume :
10
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Issue :
1
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Page :
SO12 - SO16
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Hepatic Abscess- Management and
Outcomes at Tertiary Care Center,
Garhwal, Uttarakhand
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Amit Keshri, Biant Singh, V Aironi, Santosh Kumar
1. Assistant Professor, Department of Surgery, VCSGGMS&RI, Srikot, Srinagar, Uttarakhand, India.
2. Professor and Head, Department of Surgery, VCSGGMS&RI, Srikot, Srinagar, Uttarakhand, India.
3. Professor and Head, Department of Radiodiagnosis and Interventional Radiology, VCSGGMS&RI, Srikot, Srinagar, Uttarakhand, India.
4. Specialist MD, Department of Pathology (Clinical), Tata Motors Hospital, Jamshedpur, Jharkhand, India.
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Correspondence Address :
Amit Keshri, Biant Singh, V Aironi, Santosh Kumar,
Amit Keshri,
Assistant Professor, Department of Surgery, VCSGGMS&RI, Srikot, Srinagar,
Uttarakhand, India.
E-mail: dramitkeshri@gmail.com
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| | | ABSTRACT |  |
: Introduction: Liver is the commonest organ prone to develop an abscess. Encountered in tropical and developing countries, this poses diagnostic/therapeutic challenges, and has significant associated morbidity. Hepatic abscess patients of varied aetiology commonly present in this setup at an advanced disease stage and warrant prompt recognition and remediation.
Aim: Study depicts and analyses management and outcome aspects of hepatic abscesses at the tertiary care center in Garhwal, Uttarakhand.
Materials and Methods: Hepatic abscess patients who presented and were managed between August 2015 and August 2019 at VCSGGMS&RI-UT were included in this observational descriptive study. Appropriate directed antimicrobial therapy was administered to all cases. Postresuscitation and evaluation based upon the indication and surgeon’s preference, Percutaneous Needle Aspiration (PNA) or percutaneous USGguided Pigtail Catheter Drainage (PCD) done, while exploratory laparotomy/Surgical Drainage (SD) done for complications.
Results: 70 patients (Total=70; 58 males=82.8%) presented with hepatic abscess, out of which 40 (57.1%) needed inhospital treatment for severity of symptoms. PNA was done in 25 patients (35.7%), with nine (12.8%) required multiple aspirations, PCD done in seven (10.0%) and eight (11.4%) had to undergo exploratory laparotomy/SD among the 40 Inpatient Department (IPD) treated patients. Patients in this setup had a higher number of Pyogenic Liver Abscess (PLA) (48 of 70=68.6%), with E.coli predominating (26, 37.1%), than Amebic Liver Abscess (ALA) (n=17, 24.3%); most being solitary cavities (40, 57.1%), confined to the right lobe (33, 47.1%). Alcoholism (34.3%) and hypoalbuminemia (64.3%) were associated with development as well as delayed resolution of the abscess. While seven patients required repeat interventions, most gained relief from the primary treatment modality (53, 75.7%), assessed on follow-up.
Conclusion: Antibiotics and multi-modality image-guided percutaneous management resolved most hepatic abscesses. Surgeon and intervention-radiologist collaboration recommended
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Keywords :
Amebic, Aspiration, Drainage, Percutaneous, Pyogenic
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