A CROSS-SECTIONAL STUDY OF CLINICAL FEATURES AND MANAGEMENT OF LIVER ABSCESSES IN A TERTIARY CARE HOSPITAL, AHMEDABAD, GUJARAT

Abstract

Introduction: Liver abscess is a common and major health problem in the lower socio-economic group. It can be managed with drugs, ultrasound guided needle aspiration and open surgical drainage.

Aim: The aim of the study was to assess the etiological & predisposing factors, variation in clinical presentation in liver abscesses, conservative management of small liver abscess, role of USG guided aspiration and percutaneous tube drainage androle of surgical intervention in liver abscess.

Methods: A cross-sectional study was conducted in a tertiary care hospital of Ahmedabad on 100 patients with liver abscess from 2006 to 2009. Information on socio-demographic, clinical, complications and management of the patients was collected on a pre-tested questionnaire after taking written informed consent of the patients. Data was entered and analysed in Excel.

Results: Amoebic liver abscess is more common in 30-40 age groups, while Pyogenic is more common in 50-60 age groups.Males are commonly found to be affected than females. Alcoholism and Diabetes mellitus are main predisposing factors in case of liver abscess. Most patients present with fever, abdominal pain and tenderness in right hypochondrium. Most common signs are tenderness in right hypochondrium and fever. Most common laboratory findings are hypoalbuminemia, leukocytosis and anemia. Ultrasoundhas been proven to be the most useful investigation. Nine out of 14 patients with Pyogenic Abscess& 4 out of 5 patients with Amoebic Abscessresponded to medical therapy while adjunctivepercutaneous aspiration (for abscesses smaller than 180cc on USG) was performed in 31 Amoebic & 33 Pyogenic patients.USG guided aspiration and laparotomy has the best outcome.

Conclusion: We conclude from the study that needle aspiration combined with antibiotics represent a successful therapeutic approach in the treatment of liver abscess. Open surgical drainage is usually reserved for complications like rupture in peritoneum.