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.

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.

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 Clinical study of liver abscess

2021 ◽  
Author(s):  
Chethan L.
Keyword(s):  
Liver Abscess ◽  
Serum Alkaline Phosphatase ◽  
Imaging Techniques ◽  
Secondary Infection ◽  
Elevated Serum ◽  
Signs And Symptoms ◽  
Needle Aspiration ◽  
Treatment Modalities ◽  
Endoscopic Drainage ◽  
Liver Abscesses

Background: Liver abscesses, both amoebic and pyogenic, is an important cause of morbidity and mortality in tropical countries. However, liver abscess have been managed by conservative, percutaneous needle aspiration, surgical drainage and endoscopic drainage. The aim of our study was to study the etiological, predisposing factors, signs and symptoms and various modalities of treatment of liver abscess.Methods: In this study 30 cases of liver abscess, required data was collected and was compared statistically. All cases were studied upto discharge regarding presenting signs and symptoms and treatment modalities.Results: Liver abscesses were more common in males. History of alcoholism was present in 60% of cases. The common clinical features were rt hypochondriac tenderness 100%, tender hepatomegaly 90%, fever 97%, anorexia 77%, weight loss 40%, jaundice 13%. Elevated leukocytes was seen in 72%, elevated serum bilirubin in 17%, serum alkaline phosphatase in 50 % and serum transaminase in 17% of cases. Right lobe of liver was involved in 87%, left lobe in 13%, both lobes in 0%. 23% of cases were treated conservatively, 50% by aspiration, 27% by surgical open method drainage, complications were secondary infection in 8%, rupture into peritoneal cavity 13% and pleural effusion 17%. Mortality was nil.Conclusions: The modern day ultrasound and other non-invasive imaging techniques had greatly revolutionized the diagnosis and management of the liver abscess. Conservative management with IV antibiotics and USG guided percutaneous aspiration of liver abscess are most frequent treatment modalities used now, with fewer complications. 

scholarly journals Liver abscess: study of etiological factors and different treatment modalities and their clinical implications

2019 ◽  
Vol 6 (6) ◽  
pp. 1870
Author(s):  
Abhishek Khosla ◽  
Iqbal Ali ◽  
Varun Shetty
Keyword(s):  
Liver Abscess ◽  
Surgical Intervention ◽  
Significant Risk ◽  
Hepatic Abscess ◽  
Significant Risk Factor ◽  
Liver Parenchyma ◽  
Needle Aspiration ◽  
Treatment Modalities ◽  
Age Group ◽  
The Impact

Background: Hepatic abscess (HA) can be defined as an encapsulated collection of suppurative material within the liver parenchyma, which may be infected by bacterial, fungal, and/or parasitic micro-organisms. The development of new radiologic techniques, the improvement in microbiologic identification, and the advancement of drainage techniques, as well as improved supportive care, have reduced mortality to 5-30%. The study is undertaken to study the etiology and the impact of the modern methods of treatment on the morbidity and mortality on the different types of liver abscess..Methods: This study was a Prospective Study conducted from July 2016 to September 2018. Participation in the study was purely voluntary.Results: Majority of the patients (29%) were in the age group of 31-40 years with a male preponderance (91%). Diabetes mellitus was a common comorbidity in study subjects. Alcohol consumption was found as a significant risk factor in the development of liver abscess. Sixty eight (68%) patients underwent percutaneous needle aspiration and 27 (27%) patients were managed conservatively. Five (5%) patients required surgical intervention. Four (4%) patients died while 97 (97%) patients survived; 3 (3%) patients had undergone surgery while 1 (1%) patient was percutaneously drained.Conclusions: The most common age group affected by liver abscess was third and fifth decade of life . Males are more commonly affected than females. In case of larger (>5 cm) or 150 ml, Ultrasound guided percutaneous pigtail catheter drainage is a superior therapeutic approach than percutaneous needle aspiration. Surgical intervention is reserved for unresponsive cases.

scholarly journals Hepatic Abscess in a Returning Traveler with Crohn’s Disease: Differentiating Amebic from Pyogenic Liver Abscess

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Daria Gaut ◽  
Hannah Shull ◽  
Anthony Bejjani ◽  
Daniel Kahn
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Liver Abscess ◽  
Clinical Presentation ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Amebic Liver Abscess ◽  
Liver Abscesses ◽  
Inflammatory Bowel

Liver abscess is a rare but serious complication of Crohn’s disease. Patients with Crohn’s disease are at risk for pyogenic liver abscesses due to immunosuppressive therapy, fistulous disease, and intraabdominal abscesses. Inflammatory bowel disease patients are also known to have a greater prevalence of amebiasis compared to the rest of the population; however, a higher incidence of amebic liver abscess has not been reported. We describe a case of a liver abscess in a patient with Crohn’s disease that was initially presumed pyogenic but later determined to be amebic in origin. Epidemiology, clinical presentation, diagnosis, and treatment of amebic and pyogenic liver abscesses are discussed.

scholarly journals Multiple Pyogenic Liver Abscess

2013 ◽  
Vol 5 (2) ◽  
pp. 137-139
Author(s):  
Deepak Madi ◽  
Basavaprabhu Achappa ◽  
Mridula Laxman ◽  
John T Ramapuram ◽  
Nithyananda Chowta ◽  
...  
Keyword(s):  
Liver Abscess ◽  
Complete Resolution ◽  
Medical Science ◽  
Pyogenic Liver Abscess ◽  
Needle Aspiration ◽  
Science Volume ◽  
Ultrasound Guided ◽  
Liver Abscesses ◽  
Threatening Condition ◽  
Life Threatening

Multiple liver abscess is a life threatening condition with high mortality. We present a case of a 59 yr old gentleman who developed multiple hepatic abscesses due to an appendicular mass. He was treated with parenteral antibiotics and ultrasound guided needle aspiration of the largest abscess was done. He recovered promptly with complete resolution of the liver abscesses. The main aim of this case report is to highlight the fact that multiple pyogenic liver abscesses can be managed with antibiotic treatment and needle aspiration. DOI: http://dx.doi.org/10.3126/ajms.v5i2.8725 Asian Journal of Medical Science, Volume-5(2) 2014: 137-139

scholarly journals A clinical study of liver abscess in patients attending the surgical department. A single center experience.

2021 ◽  
pp. 7-10
Keyword(s):  
Liver Abscess ◽  
Tamil Nadu ◽  
Complete Blood Count ◽  
Pyogenic Liver Abscess ◽  
Needle Aspiration ◽  
Amoebic Liver Abscess ◽  
Treatment Modalities ◽  
College Hospital ◽  
X Ray ◽  
Surgical Department

Liver abscess is a condition that is seen by surgeons all over the world. The patients present to the surgical department with features of right hypocondrial pain, fever and jaundice. Investigations such as ultrasound of the abdomen and CT scan of the abdomen are extremely useful in diagnosing a case of liver abscess. The two main causes of liver abscess are amoebic and pyogenic liver abscess. Occasionally a liver abscess may also occur due to fungal infection. Treatment modalities include the use of drugs such as metronidazole for amoebic liver abscess, as well as needle aspiration and pigtail catheter drainage when required. This was a prospective study was carried out from August 2015 to July 2018, for a period of three years. The study was conducted at SRM Medical College Hospital and Research Center, Kattankulathur, Tamil Nadu, India. Investigations such as complete blood count (CBC), chest x-ray, x-ray abdomen, ultrasound of the abdomen and CECT of the abdomen were done. A total of 57 patients were studied and the results obtained were analysed.

scholarly journals Liver abscess presentation and management: a retrospective study

2017 ◽  
Vol 4 (2) ◽  
pp. 550
Author(s):  
Kemparaj T. ◽  
Mohammed Rehan Khan ◽  
Sagar Narayan
Keyword(s):  
Retrospective Study ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Liver Parenchyma ◽  
Needle Aspiration ◽  
Amoebic Liver Abscess ◽  
Treatment Modalities ◽  
Microbiological Analysis ◽  
Right Lobe ◽  
Common Sign

Background: Liver abscess is defined as collection of purulent material in liver parenchyma which can be due to bacterial, parasitic, fungal, or mixed infection. It is a common condition across the globe. The aim was to study the clinical profile, microbiological aetiology, and investigation profile and treatment outcomes in patients with liver abscess.Methods: A retrospective study was conducted from January 2010 to December 2014 on 200 consecutive liver abscess patients at Bowring and Lady Curzon hospital, BMC and RI, Bangalore, Karnataka, India. Medical records were analysed for clinical features, examination findings, laboratory investigations, radiological tests, microbiological analysis and treatment modalities. Descriptive statistics were used.Results: The mean age of patients was 42.25 years. Majority were male alcoholics. The abscesses were commonly in right lobe (80%) and solitary (72%). Abscesses were predominantly amoebic in 72%. Percutaneous needle aspiration was done in 34%, pigtail drainage in 48% and surgical intervention for rupture in 4% patients. Mortality was 2.5% with all death reported in surgical group.Conclusions: Amoebic liver abscess is more common than pyogenic liver abscess. Commonly occurs in young alcoholic males. Most common presenting feature is pain abdomen followed by fever. Most common sign include tender hepatomegaly. Ultrasound abdomen is useful not only in diagnosis and intervention but also in the follow up of the condition and to assess resolution.

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.

scholarly journals Giant criptogenic pyogenic gas containing left liver abscess

2008 ◽  
Vol 136 (5-6) ◽  
pp. 292-294
Author(s):  
Radoje Colovic ◽  
Nikica Grubor ◽  
Vladimir Radak
Keyword(s):  
Escherichia Coli ◽  
Liver Abscess ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Diabetic Patients ◽  
Surgical Drainage ◽  
X Ray ◽  
Left Liver ◽  
Liver Abscesses ◽  
The Right

INTRODUCTION Pyogenic gas containing liver abscesses are rare. Less than 50 cases seem to have been described so far. Most of them were localised within the right liver. The majority of those abscesses appear in diabetic patients. CASE OUTLINE The authors present a 64-year old diabetic male patient in whom the investigation (US, CT, plain X-ray) performed for fever of unknown origin confirmed a giant liver gas containing abscess that destroyed almost the entire left liver. Escherichia coli sensitive to several antibiotics was isolated from the abscess. The patient was cured by surgical drainage, limited debridement, lavage, drainage and antibiotics. CONCLUSION Pyogenic gas containing liver abscesses are easy to diagnose nowadays. The type of surgical drainage has to be adapted to a particular patient.

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