VARIOUS CLINICAL PRESENTATION AND MANAGEMENT OF LIVER ABSCESS: SINGLE CENTRE STUDY.

Dr. Jignesh shah, Dr. Kartik Gorasiya, Dr. Ruchir Jhaveri

Abstract


Background and Aims: Liver abscess and its complications both can have their serious implications if presented late. Complication of liver abscess forms the major cause of morbidity and mortality especially in a developing country like India. This is a case series of our experience to highlight various clinical presentations and the outcomes of the different modalities of management of the same.

Material and Methods: During the period of September 2017 to August 2019, an observational study was performed involving 138 patients admitted to the in-patient ward of the Department of General Surgery of New Civil Hospital, Surat. Their diagnosis was made on the basis of clinical features, laboratory investigations and radiological evidence of liver abscess and management was done accordingly and the outcomes were noted.

Results: Amoebic liver abscess was the most common (66%) type of liver abscess with male preponderance (92%) among the study groups and Ultrasonography (USG) of the abdomen was accurate and cost-effective in diagnosis of liver abscesses. Antibiotic with USG (Ultrasonography) guided Percutaneous catheter drainage (PCD) was the commonest used method in this study as management. Mortality rate of 1% was noted.

Conclusion:  There are wide variety of clinical presentation of liver abscess like with jaundice, caudate lobe abscess, rupture with peritonitis and pleural rupture and its complications which are difficult to manage to this date. Antibiotic with USG guided PCD insertion is found to be the most effective treatment followed by needle aspiration. Surgical drainage is reserved for ruptured liver abscess and caudate lobe liver abscess (due to difficult approach).


Keywords


Liver abscess, USG guided PCD

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