Title: Clinical Presentation, Evaluation and Management of Liver Abscess

Author: Dr Rajiv Srivastava

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i9.111

Abstract

Liver abscess is a major tropical disease of the gastrointestinal system. The liver abscess is mainly classified into amebic and pyogenic. Pyogenic liver abscess which used to be mainly tropical in location is now more common due to increased biliary interventions, stenting, A total of 88 patients who were diagnosed to have liver abscess were included in my study after thorough clinical evaluation and ultrasonograpic study. In our study most common age group effected with this disease is between 16-45years almost 67% of the total. Male prepondence with 68.1%. of cases. Right lobe of the liver was found to be involved in 62,2% of cases and both lobe was involved in 12,5% of cases..It was single abscess cavitiy that superseded multiple cavities with its presence in 64.7% of cases and the size of largest cavity in largest diamension was found to be less that 5cm in 60.2% cases, between 6-10cm in 27.7%cases and size more than 15cm in3.4% cases. Patients with size less than 5cm responded well to conservative management. Mortality was 3.4% inpatient who did not respond to any treatment..51.1% of cases could be managed conservatively and did not need any aspiration. In 37.03% of cases ultrasonographic aspiration was done either in one sitting or multiple sitting and these patients responded well and duration of stay in hospital could be reduced. Average patients required admission between 5 to 10 days for symptomatic relief either conservatively or USG guided aspiration but few patients who showed slow response or needed multiple aspiration had to stay between 11-15 days (21.5%) of cases. We also found that it was non vegetarians who had more incidence of liver abscess 56.18% of cases. History of alcohol intake was found in 35% of cases.

Keywords: liver abscess, pyogenic liver abscess, ameobic liver abscess, ultrasonography, ultrasono-graphic guided aspiration, surgical drainage.

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