scholarly journals Clinicopathological study on presentation, diagnosis and management of liver abscess in Bhopal region

2017 ◽  
Vol 4 (8) ◽  
pp. 2572
Author(s):  
Anshul Siroliya ◽  
Mahendra Damor ◽  
M. C. Songra
Keyword(s):  
Observational Study ◽  
Liver Abscess ◽  
Prospective Observational Study ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Age Group ◽  
Catheter Drainage ◽  
Liver Abscesses ◽  
Male Preponderance ◽  
Amoebic Abscess

Background: This prospective observational study is carried out to study cases of liver abscess and to determine demographic profile, spectrum of clinical presentations, aetiology, laboratory investigations. The objective of the study was to evaluate efficacy of Ultrasonographic (radiological) studies in determining the aetiology and in differentiating from other liver pathologies which may change the treatment outcome, bacteriological and serological characteristics, to study the influence of alcohol, diabetics and immunocompromised diseases (esp. HIV) leading to increased incidence of liver abscess and to evaluate efficacy, recurrence rate, complications, morbidity and mortality, duration of hospital stay associated with different management Strategies.Methods: This prospective observational study was carried out in Department of Surgery, Gandhi Medical College Bhopal and Associated Hamidia Hospital, Bhopal between July 2015 to October 2016.Results: Amoebic abscess (74%) is more common than pyogenic abscess (26%). Amoebic abscess is common in the age group of 31-50 years (73%), pyogenic in the age group of 51-70 years (73.1%). Male preponderance is found in case of amoebic liver abscess (90.5%). Right lobe involvement in common. Right upper quadrant pain, tenderness and fever are the most common clinical features. Alcoholism is most common risk factor (71.6%) and diabetes mellitus has strong association with pyogenic liver abscess (15.4%). E coli (19.2%) and klebsiella (11.5%) are the most common organisms cultured. Medical therapy is more useful in case of amoebic liver abscess (58.1%) while catheter drainage is more useful in case of pyogenic liver abscess (61.5%). Pleuropulmonary complications are much more common and complications rate is more common among pyogenic group.Conclusions: In our study, alcohol was found to be the most common predisposing factor for liver abscesses (68%), this underpin the finding of other studies. Amoebic liver abscess is a medically treated common infection prevailing in unhygienic condition, affecting people mostly between 30-40 years of age whereas pyogenic liver abscess patient commonly falls between 50-70 years age group. Both liver abscesses show a male preponderance. The present study also corroborates the catheter drainage procedure as a superior modality in treating pyogenic liver abscess.

scholarly journals Correlation between abscess size and liver function tests in cases of liver abscess

2017 ◽  
Vol 5 (8) ◽  
pp. 3340
Author(s):  
Vineet Jain ◽  
Smita Manjavkar ◽  
Divya Rajput ◽  
Abhinav Jain ◽  
. Jyotsana ◽  
...  
Keyword(s):  
Liver Function ◽  
Serum Albumin ◽  
Liver Abscess ◽  
Liver Enzymes ◽  
Major Change ◽  
Pyogenic Liver Abscess ◽  
Liver Function Tests ◽  
Amoebic Liver Abscess ◽  
Male Preponderance ◽  
Risk Patients

Background: Liver abscess has shown a major change in demographics, etiology, diagnosis, and treatment over the past 100 years. The modern diagnostics like ultrasound and computed tomography to locate and drain the abscess have reduced the mortality to 2-12%. However, due to the complications of liver abscess especially the amebic ones the morbidity is still high. This study aims to study the correlation of various LFT parameters with abscess volume for early detection of high risk patients and early treatment thus reducing morbidity.Methods: The study was conducted over a period of 6 months on 50 patients of liver abscess. History and physical examination was done. All patients were subjected to complete hemogram, liver function test, coagulation profile (PT/INR) and USG abdomen. The data was recorded and compiled in excel sheets and analyzed using correlation coefficient (R) method.Results: The mean age of the patients was 41.2 years with male preponderance. Amoebic liver abscess (88%) was predominant over pyogenic liver abscess (12%). Alcoholism (48%), smoking (42%) and diabetes mellitus (18%) are main predisposing factors in case of liver abscess. Hepatomegaly was found in 88% cases. Elevated ALP, low albumin, increased PT INR points to the diagnosis of liver abscess. Complications seen were pleural effusion (10%) and ascites (4%). On analysis, liver abscess size is significantly positively correlated with INR, ALP, liver enzymes, and negatively correlated with serum albumin level.Conclusions: Liver abscess size was found to be positively correlated with INR and alkaline phosphatase (ALP), liver enzymes (SGOT, SGPT) and negatively correlated with serum albumin levels. There was no correlation of abscess size and bilirubin levels. Hence, LFT can be used to estimate the liver abscess size and predict the severity and prognosis of patient.

CLINICAL AND BIOCHEMICAL PROFILE OF LIVER ABSCESS PATIENTS AT MEDICINE DEPARTMENT OF ANMMCH, GAYA, BIHAR

2021 ◽  
pp. 30-32
Author(s):  
Bharat Bhushan ◽  
Debarshi Jana
Keyword(s):  
Diabetes Mellitus ◽  
Liver Abscess ◽  
Cost Effective ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Medicine Department ◽  
Male Preponderance ◽  
Right Lobe ◽  
Inadequate Nutrition ◽  
Upper Abdomen

Background: Liver comprises 48% of all the visceral abscesses. It is common in India with 2nd highest incidence due to poor sanitation, overcrowding and inadequate nutrition. Worldwide, approximately 40-50 million people are infected annually with amoebic abscesses. This study aims to observe the clinical and biochemical prole of liver abscess patients so that a prompt diagnosis can be made and early treatment can be given. Methods: The study was conducted over a period of 1 year on 50 patients of liver abscess. History and physical examination was done. All patients were subjected to complete hemogram, liver function test, coagulation prole (PT/INR) and USG abdomen. Serology for Entamoeba histolytica and HIV was done. Results: The mean age of the patients was 41.8 years with male preponderance. Amoebic liver abscess (86%) was predominant over pyogenic liver abscess (14%). Alcoholism (52%) and diabetes mellitus (20%) are main predisposing factors in case of liver abscess. Hepatomegaly was found in 80% cases. Elevated ALP, low albumin, increased PT INR points to the diagnosis of liver abscess. The abscesses were predominantly in right lobe (76%) and solitary (66%). Complications seen were ascites (12%) and pleural effusion (6%). Conclusions: Liver abscess should be suspected in patients presenting with prolonged fever and pain upper abdomen specially if patient is alcoholic or has diabetes mellitus. Ultrasonography is an easy and cost effective investigation to diagnose liver abscess. Early and aggressive treatment is the mainstay to prevent complications, morbidity and mortality

Clinical and biochemical profile of liver abscess patients

2017 ◽  
Vol 5 (6) ◽  
pp. 2596 ◽  
Author(s):  
Vineet Jain ◽  
Smita Manjavkar ◽  
Prem Kapur ◽  
. Durfishan ◽  
Divya Rajput ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Liver Abscess ◽  
Cost Effective ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Biochemical Profile ◽  
Male Preponderance ◽  
Right Lobe ◽  
Inadequate Nutrition ◽  
Upper Abdomen

Background: Liver comprises 48% of all the visceral abscesses. It is common in India with 2nd highest incidence due to poor sanitation, overcrowding and inadequate nutrition. Worldwide, approximately 40-50 million people are infected annually with amoebic abscesses. This study aims to observe the clinical and biochemical profile of liver abscess patients so that a prompt diagnosis can be made and early treatment can be given.Methods: The study was conducted over a period of 1 year on 50 patients of liver abscess. History and physical examination was done. All patients were subjected to complete hemogram, liver function test, coagulation profile (PT/INR) and USG abdomen. Serology for Entamoeba histolytica and HIV was done.Results: The mean age of the patients was 41.8 years with male preponderance. Amoebic liver abscess (86%) was predominant over pyogenic liver abscess (14%). Alcoholism (52%) and diabetes mellitus (20%) are main predisposing factors in case of liver abscess. Hepatomegaly was found in 80% cases. Elevated ALP, low albumin, increased PT INR points to the diagnosis of liver abscess. The abscesses were predominantly in right lobe (76%) and solitary (66%). Complications seen were ascites (12%) and pleural effusion (6%).Conclusions: Liver abscess should be suspected in patients presenting with prolonged fever and pain upper abdomen specially if patient is alcoholic or has diabetes mellitus. Ultrasonography is an easy and cost effective investigation to diagnose liver abscess. Early and aggressive treatment is the mainstay to prevent complications, morbidity and mortality.

scholarly journals Enhanced Drainage Protocol in Large Amoebic Liver Abscess

2021 ◽  
Vol 07 (04) ◽  
pp. e351-e356
Author(s):  
Jignesh A. Gandhi ◽  
Pravin H. Shinde ◽  
Sadashiv N. Chaudhari ◽  
Amay M. Banker
Keyword(s):  
Observational Study ◽  
Hospital Stay ◽  
Liver Abscess ◽  
Prospective Observational Study ◽  
Clinical Symptoms ◽  
Length Of Hospital Stay ◽  
Amoebic Liver Abscess ◽  
Secondary Outcome ◽  
P Value ◽  
Pigtail Catheter

Abstract Background Amebic liver abscess (ALA) contributes significantly to morbidity and mortality in patients of the developing world. Even though medical management is the primary modality of treatment, 15% of the cases are refractory and require intervention for drainage. Pigtail catheterization is inefficient and results in a long duration of hospital stay. So, we conducted a prospective observational study to determine the efficacy and safety of drainage of large ALA using a wide bore 24 French (Fr) drain compared with a conventionally used 10 Fr pigtail catheter. Materials and Methods A single center prospective observational study was conducted over a period of 5 years and data of 122 patients was collected. After starting empirical medical therapy, patients underwent drainage of ALA with either a 10 French pigtail or a 24 Fr drain. The primary outcome variables were resolution of clinical symptoms such as fever and pain in abdomen, length of hospital stay, and resolution of abscess on imaging at day 3. Secondary outcome was complications related to the procedures. Results Data of 122 patients was collected. Males constituted a vast majority (96%) of the study population and the fifth decade was the most common age group involved. Alcoholics had a higher chance of developing a large ALA. Sixty-eight patients underwent drainage of the ALA using a 24 Fr drain which resulted in faster resolution of symptoms (2.4 vs. 5.1 days, p-value 0.033), a shorter duration of catheter in situ (6.4 vs. 13.2, p-value 0.011), and a faster drainage of ALA (residual volume at day 3; 177 vs. 212 mL, p-value 0.021). Twenty-eight patients had a biliary communication of which 26 required therapeutic endoscopic retrograde cholangiopancreatography. Conclusion In patients with a large ALA, placement of a wide bore 24 Fr catheter hastens recovery of the patients when compared with drainage with a standard 10 Fr pigtail catheter. Placement of a biliary stent serves as a useful adjunct for their management and it may obliviate the need for a major biliary diversion surgery.

scholarly journals A study of clinical presentation, diagnostic difficulties and various treatment modalities of liver abscess

2018 ◽  
Vol 5 (5) ◽  
pp. 1815
Author(s):  
Sunil Kumar Dangi ◽  
Ashok Kulhari ◽  
Ashok Parmar ◽  
Ankita .
Keyword(s):  
Liver Abscess ◽  
Unknown Origin ◽  
Pyogenic Liver Abscess ◽  
Needle Aspiration ◽  
Treatment Modalities ◽  
Amebic Liver Abscess ◽  
Age Group ◽  
Pyrexia Of Unknown Origin ◽  
Liver Abscesses ◽  
Study Results

Background: Liver abscess is an uncommon entity and over past 100 years dramatic changes in demographics, etiology, diagnosis and treatment occurred. The purpose of this study was to determine the clinico-etiological demographic profile of liver abscess by using radiological studies and to evaluate the outcome associated with different treatment strategies.Methods: A prospective study was conducted over a cohort of 50 patients presenting with liver abscess. Patients diagnosed with malaria, enteric fever, pyrexia of unknown origin, acute viral hepatitis, chronic liver diseases, or hepatomegaly due to any cause, were excluded from study. Results: The amebic liver abscess was found in 32 patients and pyogenic abscess in 18 patients. The age group ranges from 16 to 78 years with mean age of 38 years and the peak incidence is found in the 31-40 years age group for both types. The M: F ratio is 7:2 in pyogenic liver abscess and 13:3 in amebic. In the present study, the most common symptoms in both types of liver abscess were pain abdomen, loss of weight, anorexia, chills and rigor, vomiting and cough. The most common signs seen in both type liver abscess were tenderness, hepatomegaly and jaundice. In both types liver abscess, right lobe was affected more commonly, and single abscess was more common. Hb <10 gm % is present in more than 50 % cases in both liver abscesses. The right dome of diaphragm elevation present in 75%-89% in both types of liver abscess. In pyogenic liver abscess group, patient had associated intra-abdominal infections. In amebic liver abscess group associated illness was not seen. Antibiotics alone used for small multiple abscesses and antibiotics with needle aspiration done for large abscess, are the main line of treatment in this series. Mortality was nil in present series.Conclusions: Liver abscesses are more common in males, alcoholics and immune-compromised patients. Percutaneous drainage with antibiotics treat majority of cases. The mortality from liver abscess has decreased but incidence appears to be increasing.

scholarly journals Liver abscess: diagnostic and management issues found in the low resource setting

2019 ◽  
Vol 132 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Gaetan Khim ◽  
Sokhom Em ◽  
Satdin Mo ◽  
Nicola Townell
Keyword(s):  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Diagnostic Strategy ◽  
Middle Income ◽  
Low Resource ◽  
Liver Abscesses ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Low Middle Income Countries

Abstract Introduction Liver abscesses are mainly caused by parasitic or bacterial infection and are an important cause of hospitalization in low-middle income countries (LMIC). The pathophysiology of abscesses is different depending on the etiology and requires different strategies for diagnosis and management. This paper discusses pathophysiology and epidemiology, the current diagnostic approach and its limitations and management of liver abscess in low resource settings. Sources of data We searched PubMed for relevant reviews by typing the following keywords: ‘amoebic liver abscess’ and ‘pyogenic liver abscess’. Areas of agreement Amoebic liver abscess can be treated medically while pyogenic liver abscess usually needs to be percutaneously drained and treated with effective antibiotics. Areas of controversy In an LMIC setting, where misuse of antibiotics is a recognized issue, liver abscesses are a therapeutic conundrum, leaving little choices for treatment for physicians in low capacity settings. Growing points As antimicrobial resistance awareness and antibiotic stewardship programs are put into place, liver abscess management will likely improve in LMICs provided that systematic adapted guidelines are established and practiced. Areas timely for developing research The lack of a quick and reliable diagnostic strategy in the majority of LMIC makes selection of appropriate treatment challenging.

scholarly journals Effective treatment options in amoebic liver abscess in a tertiary care setting in West Bengal: an observational study, India

2018 ◽  
Vol 5 (11) ◽  
pp. 3666
Author(s):  
Ankan Mondal ◽  
Arista Lahiri ◽  
Prama Ray ◽  
Atanu Bhattacharjee
Keyword(s):  
Observational Study ◽  
Liver Abscess ◽  
Treatment Options ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Amoebic Liver Abscess ◽  
Percutaneous Catheter Drainage ◽  
Care Hospital ◽  
Open Drainage ◽  
Catheter Drainage

Background: Conservative management and image guided drainage have emerged as mainstay of the treatment in Amoebic Liver Abscess (ALA), with surgery used in complicated cases. The current study was conducted with an objective to demonstrate the effectiveness of the different treatment options in ALA.Methods: An observational study was conducted on 100 patients, aged 19 to 60 years, admitted with sonographic evidence of Amoebic Liver Abscess (ALA) in the General Surgery wards of a tertiary care hospital in Kolkata. Patients coming for regular follow-up after completing treatment were included. On completion of the treatment before discharge a repeat ultrasonography of the upper abdomen was done to confirm remission.Results: Majority of the patients were male, Muslim, rural resident and within 30 – 40 years age. Chief complaints were pain (100%), fever (60%) and abdominal swelling (80%). Tender hepatomegaly (80%) and icterus (36%) were present. Majority patients had the left lobe of the liver affected (72%) and abscess dimension <6 cms (66.67%). Out of the participants with unruptured abscess 21.87% had multiple abscesses. Out of 64 patients subjected to conservative therapy, 44 were successfully managed. Success rate of 72.73% was observed among 44 patients receiving ultrasound guided needle aspiration. All twenty patients subjected for pigtail catheter drainage were cured. Four patients underwent laparotomy and open drainage following intraperitoneal rupture.Conclusions: Conservative treatment was observed to be sufficient in majority of cases of amoebic liver abscess of lesser size with percutaneous catheter drainage useful in large abscess. Surgical intervention was required in ruptured or complicated abscesses. 

scholarly journals Liver abscess: demographic, clinical, biochemical, imaging and microbial spectrum

2019 ◽  
Vol 7 (12) ◽  
pp. 4607
Author(s):  
Abdul Rabb Bhutto ◽  
Amanullah Abbasi ◽  
Shumaila Rafi ◽  
Ali Hassan Abro
Keyword(s):  
Clinical Features ◽  
Liver Abscess ◽  
Immunosuppressive Treatment ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Common Symptom ◽  
College Hospital ◽  
Cross Sectional ◽  
Aggressive Approach ◽  
Liver Abscesses

Background: Liver abscesses are localized suppurative destruction of liver tissue due to infections of either bacterial (Pyogenic) or protozoa (Amoebic). Historically; pyogenic liver abscess has been described since the time of hippocrates (400 BC). Despite the more aggressive approach to treatment, the mortality rate remained at 60-80%.Methods: This Cross-sectional analytical study carried out at Department of Medicine, Al-Tibri Medical College Hospital, Karachi, from June 2017 to December 2018. All participants of either gender with diagnosis of liver abscess were included in this prospective study. Patients with co morbidities like malignancy, autoimmune disease or on immunosuppressive treatment for any reason were excluded from the study. Following confirmation of the diagnosis; different characteristics of either type of liver abscess like demographic, clinical features, biochemical and imaging findings were evaluated.Results: Data of 73 subjects, 65(89.0%) males and 08(11.0%) females were analyzed with mean age was 45.42±14.518 years. Fifty-four (73.97%) patients had pyogenic liver abscess while amoebic liver abscess was found in 19(26.03%) subjects. Clinically, the most common symptom was abdominal pain, found in 66(90.4%) subjects, followed by fever in 61(83.6%), hepatomegaly in 47(64.4%), jaundice in 18(24.7%) and vomiting in 10(13.7%) cases. Demographics and clinical features are shown in (Table 1).Conclusions: Local trends have been changing and majority of liver abscess were of pyogenic liver abscesses. Clinically, clear differentiation between two types of abscesses is not possible always but few manifestations like typical symptoms, raised alkaline phosphatase and leucocytosis may be helpful.

scholarly journals Importation of Entamoeba histolytica and predominance of Klebsiella pneumoniae in liver abscesses: a 7-year retrospective cohort study from the United Arab Emirates

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hussam Mousa ◽  
Ghada Salameh Mohammed Al-Bluwi ◽  
Zainab Fathi Mohammed Al Drini ◽  
Huda Imam Gasmelseed ◽  
Jamal Aldeen Alkoteesh ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
United Arab Emirates ◽  
Liver Abscess ◽  
Hospital Admissions ◽  
Indian Subcontinent ◽  
Pyogenic Liver Abscess ◽  
Primary Diagnosis ◽  
Incidence Rates ◽  
Liver Abscesses ◽  
Potential Risk Factors

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.

Pyogenic Liver Abscess in Normal Children With Fever of Unknown Origin

PEDIATRICS ◽  
1976 ◽  
Vol 58 (4) ◽  
pp. 614-616 ◽  
Author(s):  
Sheldon L. Kaplan ◽  
Ralph D. Feigin
Keyword(s):  
Abdominal Pain ◽  
Liver Abscess ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Pyogenic Liver Abscess ◽  
Liver Function Tests ◽  
Blood Cultures ◽  
Normal Children ◽  
The Past ◽  
Liver Abscesses

Solitary pyogenic hepatic abscesses were identified as the cause of fever, abdominal pain, and hepatomegaly in two otherwise normal children who were seen at St. Louis Children's Hospital during the past year. Liver function tests were normal and blood cultures were negative in both patients. These cases illustrate that pyogenic liver abscess may occur in normal children and should be considered whenever fever of unknown origin is associated with abdominal complaints. Only in this way can we hope to improve upon the results cited previously, namely that the majority of liver abscesses remain undiagnosed during life.

Sign in / Sign up

Export Citation Format

Share Document