Title: Comparison between the Efficacy of Conservative Management and Ultrasound Guided Pigtail Catheter Drainage of Uncomplicated Amoebic Liver Abscess

Authors: Dr K Phani Jotsna, Dr Aachi. Srinivas, Dr Vinodh Varada

 DOI: https://dx.doi.org/10.18535/jmscr/v8i7.46

Abstract

Liver abscess is the most common condition associated with right upper quadrant pain and fever. It is a common disease of the tropical region. Liver abscess is broadly classified into the amoebic and pyogenic liver abscess. Colonic amoebae are mainly responsible for the development of an abscess. The uncomplicated amoebic liver abscess has been managed conservatively with amoebicidal and antibiotics alone or in combination with ultrasound-guided pigtail catheter or pigtail catheter alone too. According to the review of literature, the smaller the amoebic liver abscess successful was the conservative management, whereas the larger sized abscess or complicated abscess  (ruptured, pressure effect)required either open or closed drainage. An objective criterion for the management of uncomplicated liver abscess is established in the present study. Through this study, it is possible t know the mode of treatment to a particular patient with reference to the severity of the disease. 40 patients admitted from June 2018 to January 2020 with uncomplicated amoebic liver abscess were included in the present study.they were divided into two study groups 1) conservatively managed 2) PCD (pigtail catheter drainage). The success rate was measured in terms of clinical improvement, reduction of abscess cavity, need for the redo procedure. In the present study, it has been observed that the resolution of uncomplicated amoebic liver abscess is faster and easier with pigtail catheter drainage than who were managed conservatively. From this study, we can conclude that the pigtail catheter is a better modality of treatment for abscess measuring >6cm  and conservative management for those measuring <6cm

Keywords: Uncomplicated liver abscess, antibiotic therapy, USG guided drainage –pigtail catheter.

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