English

Abstract

BACKGROUND/AIM: Liver abscess though a relatively rare condition is a significant health problem in developing countries. Since the presentation, etiology and stage of the abscess varies to a large extent and in view of various possible complications that might arise in this condition defining the treatment strategies for this condition has always been a complex issue. In this study we will try to evaluate efficacy, recurrence rate, complications, morbidity & mortality, duration of hospital stay associated with various management strategies. MATERIALS AND METHODS: The following study was done in a set of 100 patients diagnosed with liver abscess admitted in our hospital. The management strategies compared includes use of antibiotics alone, Sonographic guided percutaneous drainage with Antibiotics and operative intervention in complicated cases. The efficacy, recurrence rate, complications, morbidity & mortality, duration of hospital stay associated with each management strategy was evaluated and observed. Followup was done for a mean period of 12.54 months. RESULTS: Of the 100 cases of liver abscesses included in this study, 26 cases (26.0%) who had abscess less than 200 cc or multiple small abscess involving both lobes were managed conservatively.74/100 (74%) who had abscess > 200 cc or left lobe abscesses were subjected to Intervention. Out of 74 cases patients underwent percutaneous drainage or laparotomy or laparoscopic drainage as required. There were no deaths in the study group. CONCLUSION: Thus in majority of cases percutaneous aspiration was the main form of treatment. All patients were started on antibiotics which were continued for 10- 14 days depending on improvement. Majority of patients responded excellently to percutaneous aspiration and antimicrobials. While patients who had smaller abscesses or multiple small abscesses were successfully managed with antimicrobial therapy alone but relapse rates were high. Mortality was not observed in our series. Recurrence rate was 8.0% and recurrence rate in conservatively managed group was 30.7% while that in operatively managed cases is 0%.