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. 2010 Dec 27;2(12):395-401.
doi: 10.4240/wjgs.v2.i12.395.

Pyogenic liver abscess: Changing patterns in approach

Ajaz A Malik  1 , Shams Ul Bari, Khawaja Abdul Rouf, Khurshid Alam Wani
Affiliations

Pyogenic liver abscess: Changing patterns in approach

Ajaz A Malik et al. World J Gastrointest Surg. .

Abstract

Aim: To define optimum management of the pyogenic liver abscess and assess new trends in treatment.

Methods: One hundred and sixty nine patients with pyogenic liver abscess managed at Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir (India) from July 2001 to August 2006 were studied to evaluate and define the optimum treatment.

Results: Mortality in the surgically treated group of patients was 9.4% (12/119), while those treated non-surgically had a fatality rate of 16.66% (7/42). Multiple liver abscesses treated surgically had a surprisingly low mortality of 30%. The biliary tract (64.97%) was the most common cause of liver abscess. Multiple abscesses, mixed organisms and abscess complications are all associated with a significantly increased mortality. However, the lethality of the primary disease process was the most important factor in determining survival.

Conclusion: Transperitoneal surgical drainage and antibiotics are the mainstay of treatment. Percutaneous drainage is recommended for high risk patients only.

Keywords: Antibiotics; Liver abscess; Mortality; Percutaneous drainage; Surgical drainage.

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Figures

Figure 1
Figure 1
Ultrasonographic picture showing abscess in the right lobe of the liver.
Figure 2
Figure 2
Computed tomography scan picture showing abscess in the right lobe of the liver.
Figure 3
Figure 3
Percutaneous drainage of liver abscess being carried out.
See this image and copyright information in PMC

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