Management Of Liver Abscess Research Articles

Clinical characteristics and management of liver abscess in The Gambia, a resource-limited country

Liver abscess is endemic in resource-limited countries such as The Gambia where access to advanced imaging techniques or modern treatment modalities is limited. Despite this, mortality in this cohort was low. Therefore antibiotic therapy combined with percutaneous abscess drainage remains a reasonable treatment strategy of liver abscess in resource-poor settings.

Observational Study of Clinical Profiles and Management of Liver Abscess in Hospitalized Patients: A North Indian Tertiary Care Perspective.

Background Liver abscesses are a significant health concern, necessitating prompt diagnosis and appropriate management. Spontaneous liver abscesses are a frequent reason for hospitalizations in India, particularly in the northern part. By analyzing demographics, symptoms, radiological findings, laboratory parameters, and treatment outcomes, this study will contribute valuable insights to enhance the understanding and management of liver abscesses. Aims and objective To evaluate demographic, clinical, laboratory, and radiological parameters and management options in hospitalized patients with liver abscesses at a tertiary care center. Methods This study retrospectively analyzed prospectively collected data from 150 patients diagnosed with liver abscesses who were admitted to our ward for one year. Data on demographic characteristics, clinical presentation, etiology, radiological findings, laboratory investigations, management strategies, and treatment outcomes were collected. Descriptive statistics and relevant statistical tests were employed for data analysis. Results The study population had a mean age of 40.28±12.72 years, with a male preponderance (136 (90.7%)). Amoebic abscesses (94 (62.7%)) were the most common. Hepatomegaly (144 (96%)), fever (140 (93.3%)), abdominal pain (136 (90.7%)), and anorexia (118 (78.7%)) were the most common symptoms. Ultrasonography revealed solitary abscesses (99 (66%)) to be more common than multiple abscesses (24 (16%)), with a predominant location in the right lobe (128 (85.3%)). Laboratory investigations showed leukocytosis in 121 (80.7%), elevated liver enzymes (95 (63.3%) aspartate aminotransferase (AST) and 80 (53.3%) alanine transaminase (ALT)), elevated alkaline phosphatase(ALP) in 133 (88.7%), and low albumin levels (138 (92%)) in a significant proportion of patients. Single-time needle aspiration (95 (63.3%)), percutaneous drain (36 (24%)), and surgical intervention (4 (2.7%)) were the primary treatment modalities. Serum albumin level (p<0.001) and ALP (p<0.001) were significantly low and high, respectively, in patients with hospital stays ≥10 days. Conclusions This study provides insights into patients with liver abscesses' clinical and laboratory parameters and management strategies. The findings highlight the diverse clinical presentation, varied etiologies, and the importance of radiological imaging and laboratory investigations in diagnosis and management. Tailored treatment strategies based on the patient's condition are crucial for optimizing outcomes.

Liver abscess after drug-eluting bead transarterial chemoembolization for hepatic malignant tumors: Clinical features, pathogenesis, and management.

The study aimed to investigate the clinical features, incidence, pathogenesis, and management of liver abscess after drug-eluting bead transarterial chemoembolization (DEB-TACE) for primary and metastatic hepatic malignant tumors. From June 2019 to June 2021, patients with liver abscess after DEB-TACE for primary and metastatic hepatic malignant tumors were reviewed and evaluated at our hospital. Demographic and clinical data, radiological findings, management approaches, and prognosis were retrospectively analyzed. In total, 419 DEB-TACE procedures were carried out in 314 patients with primary and metastatic liver tumors at our medical center. Twelve patients were confirmed to have liver abscesses after DEB-TACE through clinical manifestations, laboratory investigations, and imaging. In this study, the incidence of liver abscess was 3.82% per patient and 2.86% per DEB-TACE procedure. After percutaneous drainage and anti-inflammatory treatments, 10 patients recovered, and the remaining 2 patients died due to direct complications of liver abscess, such as sepsis and multiple organ failure. The mortality rate of liver abscesses after DEB-TACE was 16.7% (2/12). The incidence of liver abscess after DEB-TACE is relatively high and can have serious consequences, including death. Potential risk factors could include large tumor size, history of bile duct or tumor resection, history of diabetes, small DEB size (100-300μm). Sensitive antibiotics therapy and percutaneous abscess aspiration/drainage are effective treatments for liver abscess after DEB-TACE.

MANAGEMENT OF AMOEBIC LIVER ABSCESS IN AYURVEDA: A CASE REPORT

Liver abscesses are purulent collections in the liver parenchyma that result from bacterial, fungal, or parasitic infection. Antibiotics, percutaneous drainage and surgery are the only therapeutic solution for this condition. A 38- year young gentleman diagnosed with multiple Amoebic liver abscesses visited at Government Ayurvedic college and Hospital. He came with complaints of Jaundice, fever, pain in the abdomen and USG of abdomen showed multiple Liver Abscesses. In this case of liver abscess, after getting informed consent the patient was given an Ayurvedic treatment for 30 days without any Allopathic medicine or any invasive technique. Patient was given Panchtiktghrita guggul, Arogyavardhini vati, Agnitundi vati, Vidang churna etc. There was a significant reduction noted in the symptoms of Abscess. At the end of treatment, USG examination revealed there was no focal defect or lesion in the liver and haematological parameters were found within the reference range. There were no clinically significant adverse reactions noted in the duration of treatment. The results of this study indicate the clinical efficacy of Ayurvedic treatment in the management of liver abscess and patient gave highly satisfactory response after his treatment. The treatment outcomes in the present case indicate that classical Ayurvedic measures may be helpful to the patients of a liver abscess.

A study of different treatment modalities in management of liver abscess at tertiary care center

Background: Of all the visceral abscesses, the liver accounts for 48%. When a purulent substance collects in the liver parenchyma as a result of bacterial, parasite, fungal, or combination infections, it is called liver abscess. It is prevalent in India, accounting for the second largest prevalence, owing to insufficient sanitation, overcrowding, and malnutrition. As the liver is a susceptible organ to producing abscesses, whereas amoebic liver abscess is the utmost frequent kind of abscess in the developing world’s tropical regions, pyogenic abscess is more prevalent in affluent nations. The aims and objectives were to study the etiology, clinical manifestation, and predisposing factors of liver abscess; to compare the conservative and surgical treatment modalities of liver abscess; and to find out the outcome of these patients. Methods: After matching inclusion and exclusion criteria, 100 clinically diagnosed liver abscess patients were enrolled for this retrospective and prospective observational study. Patients were analysed for ultrasonography whole abdomen, complete blood picture and liver function test and subjected to conservative or surgical management. Results: The study group of 100 patients consisted of 83 (83%) male and 17 (17%) female with mean age of 40 years (18-70). 89 (89%) patients managed conservatively and 11 (11%) patients underwent for surgery. Patients with conservative management were found to have significant differences between outcome. Conclusions: This study concludes that conservative management has significantly better outcomes as compared to surgical management.

A Record based Analysis of Percutaneous aspiration Versus Pigtail catheter drainage in the management of Liver abscess at a tertiary care centre in Mandya

A Record based Analysis of Percutaneous aspiration Versus Pigtail catheter drainage in the management of Liver abscess at a tertiary care centre in Mandya

Management of liver abscess from intervention radiologists’ perspective

Management of liver abscess from intervention radiologists’ perspective

Percutaneous needle aspiration versus catheter drainage in the management of liver abscess: an updated systematic review and meta-analysis.

Liver abscesses differ in their aetiology, location, and number. Image-guided percutaneous drainage techniques are the currently used management for liver abscesses. We conducted our study to compare the clinical safety and efficacy of percutaneous needle aspiration (PNA) to percutaneous catheter drainage (PCD). A systematic review of major reference databases was undertaken in February 2022 for randomized controlled trials (RCTs) that compare PNA to PCD in treating liver abscess patients. The quality of the included trials was assessed using the Cochrane tool. Statistical meta-analysis was conducted using RevMan and open meta-analyst software. Fifteen RCTs were included in this review, with 1676 patients enrolled. The overall quality of the included trials was moderate, with most domains of unclear risk. PCD was superior to PNA in the success rate (RR=1.23; 95% CI [1.12, 1.36], P< 0.00001), time for achieving 50% reduction of cavity size (MD=-2.32; 95% CI [-3.07, -1.57], P< 0.00001), and time for clinical improvement (MD=-1.92; 95% CI [-2.55, -1.28], P< 0.00001). The two modalities did not differ in the days of hospital stay, duration of IV antibiotics, and time needed for total or subtotal reduction of cavity size (P= 0.36, P= 0.06 and P= 0.40, respectively). High heterogeneity levels were detected. Regarding major complications, the two modalities were equally safe (P= 0.39). PCD has a higher success rate and results in a faster 50% reduction in the abscess cavity size and clinical improvement. The two modalities are equally safe.

Management of Liver Abscess in a Child

Management of Liver Abscess in a Child

Prospective study of clinical profile and various modalities of treatment in management of liver abscess

Background: Hippocrates described about liver abscess in 460-377 B.C. Liver abscess is term for a collection of purulent material in liver parenchyma, which is due to bacterial, fungal, parasitic or mixed infection.Aims and Objectives: To study the clinical profile of patients of liver abscess, causative factors, various treatment modalities and morbidity, mortality, prognosis associated with liver abscess.Material and Methods: Prospective Observational Study conducted in Department of General Surgery, Dr. V M G M C, and Solapur from Sep 2016 to Aug 2018. The sample size was 50 liver abscess cases. Results and Observations: In total, of 50 patients, according to age showed that maximum 36% of patients were from age group 21-30 years with male involvement was 72%. Maximum patients presented with fever with chills 68%. Alcoholic is the risk factor which constitute 68% with amoebic liver abscess is more common. Right lobe of liver involve more than left lobe. Percutaneous Aspiration + Antibiotics was most used treatment modality 36%. Conclusion: Young male with age group 21-30 year more commonly affected. Fever with chills presented by most number of liver abscess, chronic Alcohol intake is a definitive risk factor, percutaneous needle aspiration + Antibiotics is preferred in patients with single abscess of size >5 cm situated in superficial segments.

Study of clinical presentation, management and prognosis of liver abscess

Background: The term "liver abscess" refers to a collection of pus in the parenchyma of the liver mainly due to the infection of microorganisms. If a liver abscess is not diagnosed early or not treated, it can be fatal, resulting in significant morbidity and mortality. Aim of the study was to study the clinical manifestations, aetiologies, and management of liver abscesses in tertiary care hospital patients.Methods: From March 2015 to August 2016, 99 patients with liver abscesses were studied in the general surgery wards of government Rajaji hospital in Madurai. In the beginning, routine examination history and blood tests were documented. Then, an ultrasound was performed in selected cases, and further treatment was performed.Results: In the current study, the most cases (48%) were from the age group of 41-50 years. We discovered that this disease is more common in men (97.97%), mainly with a history of alcohol intake, with an amoebic liver abscess (ALA) in 95% of cases. Abdominal pain (100%) and fever (57%) were the most common symptoms observed in the patients. For treatment, we used single aspiration in 30 (30.3%) cases, percutaneous catheter drainage in 25 (25.25%) cases, laparotomy and drainage in 22 (22.22%) cases, multiple aspirations in 19 (19.09%) cases, and conservative management in 3 (3.03%) of the cases.Conclusions: Liver abscesses are most commonly found in young males with a history of alcohol consumption. Unfortunately, it is still a disease that causes significant morbidity. To successfully manage the liver abscess aspiration, catheter drainage and laparotomy with drainage can be used, whether single or multiple.

Diagnosis and management of liver abscess in SCB medical college &amp; hospital

Aim: The present research aims to study clinical presentation of liver abscess in relation to demographic features, risk factors as well as effectiveness of treatment methods. Methodology: This present study was carried out in 60 patients suffering from liver abscess. Patients who were above 18 years of age were included in the present study for a period of one and half years (October 2018 to March 2020). They were treated by medical/image guided drainage/surgical (open drainage) based on the site, size and other clinical parameters of lesion. Follow up was done once in 2 weeks for first 2 months and then on a monthly basis after discharge. Results: In this study, out of 60 patients, liver abscess are present in 47 males (78.3%) and 13 are females (21.7%). Overall, most common presentation of liver abscess in our institution was abdominal pain (44%), then fever (31%). Abscess was mostly located in right lobe was 53 cases (88.3%) and most of the abscesses were solitary (90%). Conclusion: Intensive care, and use of effective antibiotic therapy have resulted in a decline in the mortality rates of liver abscess in India from 24% in earlier series to 1% to 3% in more recent studies.

“A COMPARATIVE STUDY OF USG GUIDED PERCUTANEOUS CATHETER DRAINAGE VERSUS USG GUIDED PERCUTANEOUS NEEDLE ASPIRATION IN THE MANAGEMENT OF LIVER ABSCESS”

Background: The incidence of liver abscess both pyogenic and amoebic is steadily increasing. Liver abscess is a potentially curable condition and without treatment the mortality is very high. The aim and objective of the study is to compare and correlate the therapeutic effectiveness of percutaneous needle aspiration and percutaneous catheter drainage in the management of liver abscess and to indicate the various determinants that affect the success of both the procedures. To identify and compare the morbidity and side effects associated with percutaneous catheter drainage and percutaneous needle aspiration. To compare the cost effectiveness of both the treatment options.

Analysis and Comparative Study of Catheter Drainage or Needle Aspiration in Management of Liver Abscess

Background: Liver abscess is common cause of illness in developing nations. Even with the advance investigation like ultrasonography, the diagnosis is still delayed due to the nonconclusive manifestations of disease and for that reason the tentative diagnosis is important. Methods: 60 patients were selected from L.G. HOSPITAL, Ahmedabad. Study was conducted during the period from June 2020 to October 2021. Results: Percutaneous catheter drainage is having less compliance compared to needle aspiration. Repeated procedures needed to improve the success of percutaneous needle aspiration 56.66% of the subjects presented with complications in USG guided needle aspiration group whereas only 26.66% of people presented with complications in USG guided pigtail catheter drainage group. The most common complication in needle aspiration group was re-accumulation leading to repeated aspiration 40%. The of the most common complication in catheter drainage group is blockage of drain due to thick pus 10%. Conclusions: USG guided catheter drainage and USG guided needle aspiration are equally efficient in the management of significant sized liver abscesses.

Analysis of clinical presentation, biochemical profile, and management of liver abscess in North India

Objectives: Liver abscess is a common disease in tropics with high morbidity and mortality if left untreated. It is quite prevalent among low socioeconomic population. In this study, we have analyzed the clinical and biochemical profile with management options for cases of liver abscess presented at a tertiary care hospital of Northern India. Materials and Methods: This was an observational prospective study conducted at Santosh Medical College and Hospital from March 2019 to March 2021. All patients underwent extensive clinical, biochemical evaluation and radiological examination, followed by treatment as per reports and requirement. All results were formulated in tabular form and analyzed accordingly. Results: Liver abscess is commonly seen in the Indian subcontinent. Middle-aged males are predominantly affected. Alcohol intake and diabetes are the significant risk factors. Pain abdomen and fever were the most frequent complaints. Escherichia coli was the most common organism causing pyogenic liver abscess. More than 75% of the cases can be treated with antibiotics and ultrasound-guided single needle aspiration. Conclusion: Hepatic abscess is a common disease of Indian subcontinent. Early diagnosis and treatment is essential to prevent mortality. Ultrasound has emerged as a cheaper and effective diagnostic modality. The incidence of tubercular hepatic abscess is not uncommon.

Profile of liver abscess patients admitted in a tertiary care hospital

Background and Aim: Early diagnosis and prompt intervention improve the survival and outcome in liver abscess patients. The objective of the study is to assess the clinical profile and management of liver abscess in the patients requiring admission in a tertiary care hospital.

Study of clinico-aetiological profile and management of liver abscess in a tertiary care centre

Background:Liver abscess if diagnosed late or left untreated, the disease leads to fatal course with significant morbidity and mortality.Methods:We prospectively studied the clinical presentations, aetiological factors, microbiological aetiology, management and outcome in 30 patients with liver abscess seen over a period of 6 months at our tertiary care hospital.Results:Their mean age was 50.1 (range 18 to 84) years; there were 24 (80%) males. The common symptoms were fever (80%), abdominal pain (20%) and vomiting and jaundice (10%). The common laboratory abnormalities were increased alkaline phosphatase (80%), leucocytosis (65%), hyper-bilirubinaemia (45%) and hypoalbuminaemia (70%). Abdominal ultrasonography was diagnostic in 90% of cases. Fifteen (50%) patients had positive microbial culture reports. The most common organism identified wasEscherichia coli(40%) followed byEntamoeba(15%);Pseudomonas(10%);KlebsiellaandEnterococcus(5%) andMycobacterium tuberculosisin one patient. Percutaneous needle aspiration and drainage were employed as the primary therapy in 24 patients. Biliary disease accounted for 18 cases and 6 were considered to be idiopathic. Four patients (13%) died.Conclusions:Liver abscess is a diagnostically challenging problem due to nonspecific presenting characteristics. Our observations emphasise the importance of percutaneous drainage as a mainstay of therapy.

Management of Liver Abscesses at a Teaching Hospital in Rural Haryana- A Prospective Study

Introduction: With the rise of change in imaging modalities like Computed Tomography (CT) scan or Ultrasonography (USG) the treatment of liver abscess has changed leading to reduction in morbidity and mortality. Liver abscess is more common in developing countries like India. Aim: To determine the methods for aetiological diagnosis of liver abscesses and to evaluate various methods for treatment of liver abscesses and select appropriate treatment modality on the basis of clinicomicrobiological findings. Materials and Methods: The present study was a prospective study of 60 cases diagnosed as liver abscesses both amoebic and pyogenic which were managed in rural tertiary care centre between the period of November 2018 to April 2020 were included in the study. A preformed protocol was made for the management of all patients diagnosed with liver abscess and various parameters contributing to the illness like age, gender, associated conditions and clinical features. The prognosis was evaluated and assessed by using laboratory investigations, radiological findings to check the response to treatment by selecting appropriate treatment modality. Statistical analysis was done with the help of Statistical Package for the Social Sciences (SPSS) 20.0 for windows; Chicago, USA. Results: In this study amoebic liver abscess was more common as compared to pyogenic liver abscess {42 (70%) and 18 (30%)}. Liver abscess was more common in males as compared to females (4:1). History of alcohol consumption was strongly associated with the aetiology of liver abscess. Abdominal pain was the most common symptom in these patients. Conclusion: Proper clinical evaluation along with radiological imaging modalities has led to the early diagnosis of liver abscess. Microbiological investigations like blood antibody Enzyme Linked Immuno Sorbent Assay (ELISA) for Entamoeba histolytica is not in favour of diagnosing amoebic liver abscess. Conservative management is effective for minor abscesses.

A Prospective Study on Diagnosis and Management of Liver Abscess

A Prospective Study on Diagnosis and Management of Liver Abscess

CLINICAL PROFILE OF LIVER ABSCESS: A HOSPITAL BASED PROSPECTIVE STUDY.

Objectives: Liver abscess (LA) is defined as collection of purulent material in liver parenchyma which can be due to bacterial, parasitic, fungal, or mixed infection. The liver abscess is mainly classified into amoebic and pyogenic. This present study was to evaluate the aetiology, clinical profile, management and prognosis of liver abscess patients.&#x0D; Methods: A detail history, clinical examinations and relevant investigations were performed to all liver abscess patients. Investigations was performed like as routine blood investigations, chest x-ray, PA view, X-ray abdomen, AP view, ultrasound abdomen, CT scan abdomen (if needed). Culture and sensitivity of the aspirate was performed.&#x0D; Results: Data was analysed by using simple statistical methods with the help of MS-Office software.&#x0D; Conclusions: Liver abscess was commonly seen in elderly age groups. Male was more preponderance than females. Amoebic liver abscess was commonly found. Amoebic liver abscess was commonly seen in alcoholic patients. Abdominal pain, fever and abdominal distension were common clinical symptoms. Tenderness on right hypochondrial, intercostal region and hepatomegaly were the common clinical sign of liver abscess. Abscess was mostly seen in right lobe than left lobe. Most of the patients were managed by percutaneous single aspiration. If aspiration was failed, percutaneous catheter drainage was the choice for management of liver abscess. Hence, A very prompt recognition is important in instituting effective management and achieving good outcomes. Because of the nonspecific symptoms and laboratory findings, the presence of predisposing factors can be helpful in increasing the level of diagnostic suspicion. The key to successful outcome in the management of liver abscess is early diagnosis and appropriate therapy.&#x0D; Keywords: Liver abscess, age group, amoebic liver abscess, pyogenic liver abscess, alcoholic, management of liver abscess