Catheter Drainage Of Liver Abscess Research Articles

Hepato-Cutaneous Fistula: A rare delayed complication after healed Pyogenic Liver Abscess

Hepato-cutaneous fistula is a rare clinical entity which develops commonly after a complication due to hydatid disease of the liver. Few cases of it have also been reported following percutaneous catheter drainage of liver abscess due to actinomyces,burkholderia pseudomallei and entamoeba histolytica. In case of hydatid cyst of liver, it develops following spontaneous rupture or some intervention. In rest other, it always follows the percutaneous catheter drainage as a part of active underlying diseases process. Here, we report a case of Hepato-cutaneous fistula which develops four weeks after successful treatment of pyogenic liver abscess with complete resolution of abscess cavity.

Percutaneous Catheter Drainage of Liver Abscess- A Best Minimally Invasive Procedure

Percutaneous Catheter Drainage of Liver Abscess- A Best Minimally Invasive Procedure

English

English

Obstructive Jaundice: A Rare Presentation of Amoebic Liver Abscess

Jaundice is a relatively uncommon finding in amoebic liver abscess and if present, is a marker of abscess erosion into biliary tract. In these cases, other causes of jaundice are secondary infection of amoebic liver abscess (ALA), pressure of the abscess on hepatic ducts, parenchymal damage or, sometimes could be cholestatic in nature. In our case, a twenty-five year-old male student presented with jaundice and fever. There was hepatomegaly and a mass of approximately 8x6 cm protruding into right hypochondrium and epigastrium. Jaundice occurred in this case due to compression of the hepatic ducts confluence by a large abscess, thus causing bi-lobar intrahepatic biliary dilatation (IHBRD). Patient was treated by ultrasound guided catheter drainage of liver abscess and metronidazole administation in view of positive amoebic serology. Patient showed clinical improvement, catheter was removed after four days and he was later discharged. On follow-up after two weeks, his bilirubin levels had returned to normal and a review ultrasound of abdomen showed no residual abscess. Prompt drainage of abscess upon diagnosis is important to relieve jaundice and prevent catastrophic complications such as peritonitis or empyema secondary to its rupture, pleural or pericardial effusion, splenic vein thrombosis and cholangitis.

Prospective randomized comparison of ultrasound-guided percutaneous needle aspiration with percutaneous catheter drainage of liver abscesses

Background and Aims: Modern treatment of liver abscesses comprises combination of antibiotics and image-guided percutaneous needle aspiration (PNA) or percutaneous catheter drainage (PCD). However, there is debate regarding the choice of these interventions as the first line of management. Our aim was to compare the results of ultrasound-guided PCD with PNA in the management of liver abscesses. Materials and Methods: A total of 66 patients (55 males; 11 females, 18–65 years) who were diagnosed with liver abscesses were randomly divided into two groups of 33 patients each, namely ultrasound-guided PNA group (with a maximum of three attempts) and the PCD group. The outcomes of the treatment of the patients of these groups were documented and analyzed. Results: PNA was effective in 20 (61%) of the 33 patients after one (n = 14), two (n = 4), or three (n = 2) aspirations while PCD was therapeutic in all 33 patients after one (n = 29) or two (n = 4) procedures and without any major complications in both groups. All abscesses 45 mm or less in longest dimension were efficaciously managed, by both PCD as well as PNA while the later failed in case of multiloculated abscesses. The mean duration of intravenous antibiotics and time to clinical relief were significantly lesser in the PCD group. However, a period of hospital stay and time to complete resolution of abscess cavities did not differ significantly between the groups. Conclusions: Overall, PCD is more effective than PNA in the management of liver abscesses; the later, however, can be employed for smaller and simple abscesses.

Percutaneous aspiration versus catheter drainage of liver abscess: A retrospective review.

A review of the effectiveness and outcomes in liver abscess drainage performed by different operators using percutaneous aspiration (PA) and catheter drainage (PCD), respectively, from 2008-2013 at Sir Charles Gairdner Hospital, a tertiary hospital in Australia. Forty-two patients (29 males and 13 females; aged between 28-93 years; median age of 67 years) with liver abscesses underwent either ultrasound or CT-guided PA (n=22) and PCD (n=20) in conjunction with appropriate antimicrobial therapy. A median of 18 Gauge needle and 10 French catheters were utilised. Nineteen (86.4 per cent) PA cases and 12 (60 per cent) PCD cases were successfully drained on a single attempt (p=0.08). More male patients (69 per cent) than females (31 per cent) were observed. Portal sepsis (42.9 per cent) was the most common cause identified. Fever (47.6 per cent) was the most frequent clinical presentation on admission. Thirty-two patients (76.2 per cent) had solitary abscesses with a right lobe (59.5 per cent) predilection. CRP was significantly raised. The PCD group observed a significantly larger abscess size (p=0.01). Klebsiella pneumoniae was the most common organism isolated in both pus (33.3 per cent) and blood cultures (11.9 per cent). Five procedure-related complications were noted, all in the PCD group. Thirty-day mortality was 2.4 per cent. No difference was observed in clinical and treatment outcomes in both groups. The null hypothesis that both PA and PCD are equally effective in the drainage of liver abscess cannot be rejected. Apart from PA being simpler and safer to perform, the higher incidence of indwelling catheter-associated complications suggests that a trial of PA should always be attempted first.

Retained Percutaneous Tube—A Misery of Illiteracy

Percutaneous catheter drainage of liver abscesses is an established technique. Intracavitatory knotting of the tube is a rare and potentially preventable complication that can involve significant morbidity. However, because of the rarity of this complication, there remains a persistent lack of awareness in the clinical community. The risk of tube knotting can be reduced with proper technique and correct choice of tubes.

Percutaneous Catheter Drainage of Liver Abscess: Clinical Outcome

Percutaneous Catheter Drainage of Liver Abscess: Clinical Outcome