“A Prospective Study Of Clinical Profile & Management Strategies Of Liver Abscess ”
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
Objective: To study clinical profile and etiology of liver ,to determine the role of ultrasonography in the management of liver abscess and the outcome associated with different treatment strategies of liver abscess. Materials and methods:All patients with liver abscess 2015 to 2018 were included in this study.50 patients with Liver abscess who reported to various departments of Subharti medical College, Meerut, were included in the study. The patients were treated with antibiotic alone for abscess size<5 cm, patients were treated with percutaneous needle aspiration for abscess size 5-10cm and for abscess more than 10cm patients were treated with pigtail catheterization. Those patients who presented with rupture liver abscess were treated by surgical approach by laparotomy. PNA was repeated every third day if the cavity size had not declined to 50% of the original for up to twice times on repeat USG. Persistence of cavity or of clinical symptoms was considered failure of treatment. Results: Out of 50 patients 9 patients were treated with antibiotic alone.14 patients were treated with percutaneous needle aspiration .20 had to be treated with pigtail catheterization. 3 patients were treated by surgical approach by laparotomy.1 patient was treated with antibiotics alone failure followed by PNA and 3 were treated with PNA failure followed by pigtail catherisation.The maximum amount of pus that was aspirated by needle aspiration was approximately 200cc.whereas in pigtail catherisation as much as 1000cc of pus was evacuated over 2 weeks. Conclusion: Abscess size less than 5 cms can be treated conservatively with antibiotics alone.Further needle aspiration is also a good modality of treatment for abscess 5-10 cms in size.Pigtailcatherisation(PCD) was considered the most effective modality of treatment for abscess size>10 cms with nearly 100% success rate. Thus we can conclude that PCD is the most effective conservative modality of treatment for liver abscess. However in cases of ruptured liver abscess surgical exploration with laparotomy is the only modality of treatment with significant morbidity and mortality rate due to septicaemia and respiratory complications.
Authors and Affiliations
Maheswari Mukesh, Rastogi Aditya, Rashid Zubair, Verma Sameer
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