Successful percutaneous drainage of large and multiloculated pyogenic liver abscesses in critically ill patients

Evgeni Brotfain,Moti Klein

doi:10.5348/ijcri-2014-01-429-cs-2

Abstract

Introduction: Pyogenic liver abscess continues to be a fatal illness in gastrointestinal, surgical, and critical care fields. the main clinical strategy in large liver abscesses is continued to be dilemmatic between computed tomography (ct)-guided drainage, wide broad spectrum of antibacterial therapy, and urgent abdominal surgery. case series: Herein, we presented two cases of multiloculated, large liver abscesses in critically ill patients treated successfully by ct-guided

Highlights

Pyogenic liver abscess continues to be a fatal illness in gastrointestinal, surgical, and critical care fields
The main clinical strategy in large liver abscesses is continued to be dilemmatic between computed tomography (CT)-guided drainage, wide broad spectrum of antibacterial therapy, and urgent abdominal surgery
Case Series: we presented two cases of multiloculated, large liver abscesses in critically ill patients treated successfully by CT-guided drainage and antibacterial therapy

Summary

Introduction

Pyogenic liver abscess continues to be a fatal illness in gastrointestinal, surgical, and critical care fields. We describe two clinical cases of large, multiloculated liver abscesses in severe critically ill patients. Case 1: A 68-year-old male has been transferred to our intensive care unit (ICU) from the emergency room after two weeks of fever (38.7 °C), progressive fatigue, and vomiting. After initial resuscitation and initiation of broad-spectrum antibiotic therapy (metronidazole and cefuroxime), the patient underwent total body computed tomography (CT) scan which revealed a large (10x9 cm), multiloculated liver abscess in right lobe and small foreign body in the sigmoid colon (Figure 1A–B). Case 2: An 85-year-old female initially presented to surgical ward with severe abdominal pain, fever (39°C), nausea and vomiting She was hemodynamically stable with no evident respiratory distress.

DISCUSSION

CONCLUSION