A STUDY OF PRESENTATION AND MANAGEMENT OF 30 CASES OF COMPLICATED AMOEBIC LIVER ABSCESS

Abstract

BACKGROUND AND AIMS: Liver abscess and its complications both can have its serious implications if presented
late. Complication of liver abscess forms the major cause of morbidity and mortality especially in a developing country
like India. Early detection of complications with use of modern radiological modalities and its appropriate management
can reduce the associated morbidity and mortality.
METHODS : A Case series of 30 patients with ruptured liver abscess with clear signs of peritonitis( generalized
guarding and rigidity) or pleural cavity rupture(breathlessness, chest pain, cough with expectoration) were included
in study. A preformed protocol for management was followed for all the patients and accordingly various surgical
interventions were considered in the patients.
RESULTS: In this study of 30 patients, majority of affected were male (80%) with most common affected age group of 30-
60 years. Most common presentation was Localized tenderness over right hypochondrium(100%). In patients with
peritoneal or pelvic cavity rupture, generalized guarding and rigidity (86%) and in patients with pleural cavity rupture -
chest pain, breathlessness or cough with expectoration (20%) is the common presentation. Most of the patients were
managed with surgical exploration in the form Laparotomy with peritoneal lavage, laparoscopic drainage, intercostal
drain placement and thoracotomy with decortication.
CONCLUSION: In our study we have found that complications of liver abscess needs early surgical intervention to
reduce morbidity and mortality associated with complicated liver abscess.