Clinical Profile and Evaluation of Various Therapeutic Measures in the Management of Liver Abscess

Abstract

Background: Liver abscess (LA) is defined as collection of purulent material in liver parenchyma, which can be due to bacterial, parasitic, fungal, or mixed infection. As amoebic liver abscess and pyogenic liver abscess are commonly encountered in Indian subcontinent and there are various management options available like conservative management, US/CT guided aspiration/catheter drainage, or surgical drainage without definite guidelines. Recently, there is increase in radiological guided aspiration/catheter drainage of liver abscess, but in some cases it is not even required and in others there is incomplete evacuation of the abscess finally requiring surgery. Hence, we have evaluated the various therapeutic approaches in the management of liver abscess. Aims and Objectives: To study clinico-pathological profile of liver abscess and to evaluate different therapeutic approaches in the management of liver abscess. Materials and Methods: This is an observational study of 65 patients, presented in outpatient and emergency department. The clinical profile of these patients was studied. The patients underwent conservative management/Needle aspiration/Catheter Drainage/Surgical treatment depending on the size of the abscess cavity. The effectiveness of either treatment was measured in terms of a decrease in the pain score, duration of hospital stay, a decrease in the TLC count, 50% reduction in abscess cavity size, and the time taken for effervescence of fever. Independent t-test and Chi-square test were used to analyze these parameters. Results: A significant improvement was seen in the patients of both ALA and PLA who underwent catheter drainage as compared to other modalities of treatment, which were used in this study. Conclusion: Percutaneous catheter drainage is a better modality as compared to percutaneous needle aspiration especially in larger abscesses which are partially liquefied or with thick pus.