A STUDY OF PRESENTATION AND MANAGEMENT OF 60 CASES OF COMPLICATED AMOEBIC LIVER ABSCESS

Abstract

BACKGROUND AND AIMS: Liver abscess and its complications both can have its serious implications if presented late. Complication of liver abscess forms the major cause of morbidity and mortality especially in a developing country like India. Early detection of complications with use of modern radiological modalities and its appropriate management can reduce the associated morbidity and mortality.

METHODS : A Case series of 60 patients with ruptured liver abscess with clear signs of peritonitis( generalized guarding and rigidity)or pleural cavity rupture(breathlessness, chest pain, cough with expectoration)were included in study. A preformed protocol for management was followed for all the patients and accordingly various surgical interventions were considered in the patients.

RESULTS: In this study of 60 patients, majority of affected were male 48(80%)with most common affected agegroup of 30- 60 years. Most common presentation was Localized tenderness over right hypochondrium 60(100%). In patients with peritoneal or pelvic cavity rupture, generalized guarding and rigidity 52(87%)and in patients with pleural cavity rupture- chest pain, breathlessness or cough with expectoration12 (20%) is the common presentation. Most of the patients were managed with surgical exploration in the form Laparotomy with peritoneal lavage, laparoscopic drainage, intercostal drain placement and thoracotomy with decortication.

CONCLUSION: In our study we have found that complications of liver abscess needs early surgical intervention to reduce morbidity and mortality associated with complicated liver abscess.