scholarly journals Both laparoscopic and open surgical drainage are highly effective in the treatment of refractory pyogenic liver abscess: A multi-institutional analysis

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e244
Author(s):  
R. Groeschl ◽  
E. Baker ◽  
K. Bertens ◽  
I. Siddiqui ◽  
M. Tee ◽  
...  
2012 ◽  
Vol 36 (1) ◽  
pp. 106
Author(s):  
Yusri Dianne Jurnalis ◽  
Delfican Delfican ◽  
Yorva Sayoeti

AbstrakAbses hati piogenik merupakan suatu kondisi yang berat dan mengancam kehidupan dengan angka mortalitas yang tinggi sehingga membutuhkan diagnostik dan terapi yang akurat. Gejala yang paling sering ditemukan adalah nyeri perut bagian atas, hepatomegali, demam tinggi, mual dan muntah. Gejala ini bervariasi sesuai ukuran abses, keadaan umum pasien, adanya penyakit dasar dan komplikasi. Pada sebagian besar kasus, penyakit dasarnya tidak diketahui. Abses biasanya soliter dan terletak di lobus kanan hati. USG dan CT scan abdomen merupakan sarana diagnostik utama. Abses hati piogenik diterapi dengan aspirasi perkutaneus bersamaan dengan antibiotik. Jika gagal, drainase dengan pembedahan dibutuhkan. Dengan adanya terapi invasif yang minimal seperti aspirasi jarum perkutaneus atau drainase kateter yang dipandu secara radiologis serta ketersediaan antibiotik berspektrum luas, pasien jarang membutuhkan tindakan pembedahan saat ini.Kata kunci : abses hati piogenik, aspirasi perkutaneus, drainase bedahAbstractPyogenic liver abscess (PLA) is a serious, life threatening condition with a high mortality rate that represents a diagnostic and therapeutic challenge. The most common presenting clinical symptoms are upper abdominal pain, tenderness, hepatomegaly, high-grade fever, nausea and vomiting. These features are variable depending upon the size of the abscess, general health of the patient, associated diseases and complications. In majority of the cases, the underlying cause could not be identified. Majority of abscesses are solitary and are noted in the right lobe of liver. USG and CT of the abdomen are the main tools of diagnosis. PLAs are mainly treated by percutaneous aspiration under antibiotic cover. If fails, surgical drainage becomes necessary. However, with the advent of minimally invasive therapy such as image-guided percutaneous needle aspiration or catheter drainage and the availability of broadspectrum antibiotics, patients with PLA nowadays seldom require open surgery for treatment.Key word : pyogenic liver abscess, percutaneous aspiration, surgical drainage


Author(s):  
Hussam Mousa ◽  
Ghada Salameh Mohammed Al-Bluwi ◽  
Zainab Fathi Mohammed Al Drini ◽  
Huda Imam Gasmelseed ◽  
Jamal Aldeen Alkoteesh ◽  
...  

Abstract Background There is a dearth of information on liver abscesses in the United Arab Emirates. Herein, we describe the clinical features of liver abscesses and determine their incidence rates and clinical outcomes. Methods We retrospectively reviewed the clinical charts of adult patients with a primary diagnosis of liver abscess at a major hospital over a 7-year period. Results Amongst 45 patients, 82.2% (37/45) had a pyogenic liver abscess (PLA) and 17.8% (8/45) had amoebic liver abscesses (ALA). Overall, patients were young (median age 42 years, IQR 35–52), mostly males (77.8%, 35/45) from the Indian subcontinent (55.6%, 25/45), presented with fever (88.9%, 40/45) and abdominal pain (88.9%, 40/45), and had a solitary abscess on imaging (71.1% (32/45). Crude annual incidence rates were 35.9/100,000 hospital admissions (95% CI 26.2–48.0) and 5.9/100,000 inhabitants (95% CI 4.3–7.9). All ALA patients were from the Indian subcontinent (100%, 8/8). Klebsiella pneumoniae was the most frequent pathogen in PLA (43.2% [16/37], 95% CI 27.1–60.5%). The hospital stay was shorter in ALA (7.5 days, IQR 7–8.5) than in PLA (14 days, IQR 9–17). No deaths were recorded within 30 days of hospitalisation. Conclusions ALA was exclusively seen in migrants from the Indian subcontinent, suggesting importation. Further research to characterise K. pneumoniae isolates and assess potential risk factors is needed.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuangjun He ◽  
Jie Yu ◽  
Hairong Wang ◽  
Lifeng Wang ◽  
Yi Chen ◽  
...  

Abstract Background Highly empiric use of carbapenem in pyogenic liver abscess (PLA) is widespread problem. However, few studies have examined the association between blood culture and carbapenem use in patients with PLA in China. Thus, we conducted this observational study. Methods The data of patients diagnosed with PLA at two comprehensive tertiary care centers from 2014 to 2020 were retrospectively collected. Demographic and clinical data were analyzed, and univariate and multivariate analyses were performed to investigate the association between blood culture and carbapenem use. Subgroup analysis was conducted to explore whether the effect is different in sepsis. Results Blood culture was performed in 110 (46.0%) patients, of whom 44 (40.0%) patients had positive results for bacterial culture. Extended-spectrum beta-lactamase (ESBL)-positive blood culture isolates were detected in 8 (7.3%) patients. The positivity rate of blood culture in sepsis was higher than in non-sepsis (58.1% vs. 32.9%, P = 0.015). Fewer patients who had a blood culture received carbapenem treatment in comparison to patients without blood culture (19.1% vs. 31.8%, P = 0.026). Multivariate analysis showed that blood culture was independently associated with less carbapenem exposure (adjusted odds ratio [OR] = 0.33, 95% confidence interval [CI]: 0.16–0.68, P = 0.003), and this effect remained significant in the sepsis subgroup (adjusted OR = 0.17, 95% CI: 0.05–0.53, P = 0.002). Conclusion Blood culture had a high positivity rate and was associated with less carbapenem use in PLA, especially those who developed sepsis. More attention should be paid to performing early blood culture and less carbapenem use in PLA.


Metabolism ◽  
2021 ◽  
Vol 116 ◽  
pp. 154605
Author(s):  
Hana Chaabouni ◽  
Fatma Smaoui ◽  
Houcine Allouch ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
...  

2007 ◽  
Vol 45 (6) ◽  
pp. 801-801 ◽  
Author(s):  
Y. Keynan ◽  
E. Rubinstein

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