Pyogenic Liver Abscess: Demographic, Clinical, Radiological and Bacteriological Characteristics and Management Strategies

Qurban Ali Bugti, Mohammad Aslam Baloch, Ahsan ul Wadood, Akther Hameed Mulghani, Bushra Azeem, Jamil Ahmed

Abstract


Objective: To determine the demographic, clinical, radiological and bacteriological characteristics of pyogenic liver abscess and its management strategies.

Material & Methods: A total of 84 consecutive patients with pyogenic liver abscess were managed at Department of Surgery, Unit III, Bolan Medical Complex Hospital, Quetta, between February 2002 to May 2005. The investigations conducted were abdominal ultrasound, chest x-ray, complete blood picture, liver function tests and heamagglutination tests. Depending upon the size of the abscess the patients were managed by parenteral antibiotics and percutaneous needle aspiration, catheter drainage or open surgery.

Results: Pyogenic liver abscesses were common in males (Male to female ratio 3:1) and predominantly involved the right lobe of liver; more than 95% of liver abscesses were noted in the right lobe. Fourteen percent abscesses were multiple, while remaining ones were solitary. They were noted to be more common in old age patients. The blood culture and abscess aspirates revealed Klebsiella pneumoniae as the most common etiological agent. Eighty-five percent of the cases were diagnosed correctly on abdominal ultrasound. Percutaneous needle aspiration combined with parenteral antibiotics was the most successful therapy with cure rate of 90%. Overall hospital mortality rate was 6%.

Conclusion: Pyogenic liver abscess is more common in elderly males. It needs rapid diagnosis by high index of suspicion and abdominal ultrasound. Administration of appropriate parenteral antibiotics and ultrasound guided aspiration improves the prognosis.


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© 2011 Gomal Journal of Medical Sciences