A STUDY ON ETIOLOGY, CLINICAL MANIFESTATIONS AND OUTCOME OF MANAGEMENT OF LIVER ABSCESS

Dr Shaikh Mohd Arsalan Mohd Abdul Wahid, Dr S. S. Roy Chowdhury, Dr. Debarshi Jana

Abstract


In recent years imaging guided percutaneous drainage using catheters has been increasingly used to treat liver abscesses with reported success rates
ranging from 70-100%.
The aim of the present study is to find out the demographic distribution, different modes of presentations, risk factors association, alteration of
various laboratory & radiological investigations in diagnosis of liver abscess & responses to standard institutional management strategies.
In this prospective observational study, 60 clinically suspected and/or ultrasonographically diagnosed cases of liver abscess presenting to OPD, ER
and wards of General surgery, Medical college and hospital, Kolkata, during January 2017 to June 2018 were enrolled.
Majority (60%) of patients presented acutely within 7 days of onset of illness. Subacute presentation and chronic presentation was noted in 30%
,10% cases respectively. Liver functions were deranged in almost all the cases. Hypoalbuminemia was observed in 85% cases. Mean serum ALP
level was elevated more than twice and elevation was seen in 85% cases. Mean SGOT and SGPT levels were also elevated almost 4 times the
normal upper limit. Hyperbilirubinemia was observed in 20% of cases and prothrombin time was elevated in almost half the cases. Complications
of liver abscess like intra abdominal rupture and peritonitis, septicaemia, pleural rupture and cholangitis were observed.
Ultrasound is simple, inexpensive and quick to perform, with a diagnostic accuracy of 90%. It helps in determining the number, size and site of
abscess and can be used as guide for percutaneous aspiration. Percutaneous aspiration is a very effective modality of treatment in uncomplicated
cases. Surgery (Laparotomy) should be reserved for complications like rupture of abscess & peritonitis. Improvement in life style, provision of
clean uncontaminated water and abstinence from alcohol could be a major boost in direction of elimination of this notorious disease.


Keywords


Liver Abscess, Clinical Manifestations, Outcome

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References


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