Liver abscess presentation and management: a retrospective study

Abstract

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.