Presentation, demography and management of Liver abscess patients in a tertiary care hospital of India

Abstract

Background: Liver abscess (LA) is a cause of significant morbidity and requires timely management to prevent fatality. Aim: To study the demographic features, clinical presentations, and outcomes of liver abscess in Northern India. Material and methods: A prospective observational study was conducted on consecutive liver abscess patients presenting to a tertiary care centre treated from August 1, 2017, to 31, December 2020. The study participants were followed up for a period of one year Demographic features, clinical presentation and outcome were recorded and analyzed. Results: There were 83 males and 4 females, with mean age of 39.67 ± 11.85 years (ranging 13 to 70 years). History of alcohol intake was present in 85% (74/87) patients. The presenting symptoms were right upper abdominal pain in 91.95% (80/87), fever in 87.36% (76/87), nausea and/or vomiting 82.76% (72/87) and jaundice in 10.34% (9/87) cases. The commonest identifiable cause was colitis (11.5%). Majority of cases had a single abscess with involvement of right lobe of the liver. Out of 87 patients, 21 were cured with medical management and 56 additionally with ultrasound-guided percutaneous needle aspiration and drainage. Open drainage was performed 10 patients, of which 4 died. Conclusion: Early diagnosis and prompt institution of appropriate therapy is imperative in the management of liver abscess. Open drainage should not be delayed in cases lacking response to conservative treatment.