Abdominal abscess after liver transplantation: its diagnosis and treatment

Abstract

Objective To explore the etiology, diagnosis and treatment protocol of abdominal abscess after liver transplantation. Methods Clinical data of liver transplantation in our hospital were reviewed, in which 8 cases of abdominal abscess after liver transplantation were found. The pre-operational diagnosis was studied, as well as their pre-operational liver function, pre-operational infection state, operational duration, non-hepatic duration, vohumae of blood loss, post-transplantational subphrenic hematoma, anti-rejection protocol and post-transplantational biliary complications. Also the diagnosis and treatment regimen of post-transplantational abdominal abscess were studied. Results The rate of post-transplantational abdominal abscess was 2. 2 % (8/314), in which 6 cases were diagnosed as having liver abscesses, 2 cases having subphrenic abscess. No specificity was found in their pre-operational liver function, pre-operational infection state, operational duration, non-hepatic duration, volume of blood loss, post-transplantational subphrenic hematorma or anti-rejection protocol, while all cases suffered from biliary complications. The onset of abdominal abscess ranged from 1 to 50 months after liver transplantation. Diagnosis of abdominal abscess depended on symptoms and image examination. Definite diagnosis could be made by bacteriological detection, which could be used as further guidance of medication. Treatment regimen included administration of sensitive antibiotics, abscess paracentesis and abscess drainage Two cases were died due to uncontrollable infection and the remaining 6 cases survived. Conclusions Post-transplantational abdominal abscess may be related with biliary complications. Patients may survive with positive treatment regimen. Key words: Liver transplantation; Liver abscess; Subphrenic abscess; Biliary tract