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Year :2016
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Month :
January-February
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Volume :
5
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Issue :
1
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Page :
25 - 29
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Liver Abscess – A scourge of the Tropics
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Correspondence Address :
Sharad Seth, Seema Seth,
Dr. Sharad Seth,
D-4 Professors Quarters Rohilkhand Medical College and
Hospital, Pilibhit Bypass Road, Bareilly-243006, India.
E-mail: Sharad_seth2002@yahoo.co.in
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Introduction: Introduction: Liver abscess defined as a collection of pus within the liver parenchyma continues to remain a scourge for the population in our limited resource area. Amoebic and pyogenic etiologies predominate. Despite radiological advancements, minimally invasive therapeutic measures and availability of effective antibiotics, morbidity and mortality continue to remain high in cases of liver abscess.
Aim: The present study was carried out to document the various modalities of diagnosis and treatment of liver abscess in our set up and to study what changes may have occurred overtime in these parameters.
Materials and Methods: This prospective study was carried out in the Departments of Surgery and Medicine, Rohilkhand Medical College and Hospital, Bareilly between 15th September 2014 to 15th September 2015. Thirty five newly diagnosed patients of liver abscess confirmed by imaging and aspiration were included in this study. Demographic data, clinical presentation, radiological findings, management, hospital stay and follow-up of all patients was entered in a predesigned proforma for this purpose and a proportional analysis of the data was done using SPSS software version 15.
Results: Liver abscess was commoner in males 32(91.4%) as compared to 3(8.6%) female patients. Amoebic liver abscess was the cause in 20(57.15%) patients the rest 15(42.85%) were those of pyogenic liver abscess. Haematogenous spread from a septic focus was the commonest source for 8(53.33%) of pyogenic abscesses. 21(60%) of all the abscesses affected the right lobe of liver. Pain in the right hypochondrium/epigastrium was the commonest symptom in 28(80%) patients. Ultrasound of the abdomen with a sensitivity of 91.42% and CECT abdomen with a sensitivity 100% were the diagnostic modalities of choice. All patients of amoebic liver abscess received metronidazole and the commonest additional measure was needle aspiration in 10(50%) of patients. Appropriate antibiotic with needle aspiration was also the commonest procedure in 8 (53.33%) of patients with pyogenic liver abscess.
Conclusion: Amoebic and pyogenic liver abscesses continue to plague the poor population in our region. Antibiotics and ultrasound guided percutaneous needle aspiration which provides immediate pain relief are effective treatment for both.Clinical progress of the patient rather than blind reliance to ultrasound findings of an abscess cavity which may take up to three months to resolve should guide therapy.
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