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

Abstract

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