Pyogenic Liver Abscess: an Analysis of 123 Cases

Background: Pyogenic hepatic abscesses are uncommon conditions that present diagnostic and therapeutic challenges to Surgeons. If left untreated, these lesions are invariably fatal. Pyogenic Liver Abscess (PLA) has lower mortality rate in recent year due to the modern management of liver abscesses, facilitated by advances in diagnostic and interventional radiology and improved intensive care services. Method: A prospective observational study was conducted from September 2011 to June 2014, in Second Hospital of Lanzhou University. We reviewed and summarized the clinical presentations, etiology, diagnostic modalities, and treatment programs of all liver abscesses, morbidity and mortality rate. Result: A total 123 patients, studies indicate that the Liver abscess was more common in male (80 males, 43 females), approximately M: F=2:1, occurring more frequently in right lobe of liver. Mostly, patients presented with non-specific constitutional symptoms and signs such as fever (94.8%) with chills & rigors (70.7%) and some were presented with jaundice and altered LFTs. The most common organism is the Klebsiella pneumonia with E. coli. All patients were treated with individual or combined therapies including antibiotics, USG-guided drainage 61(49.6%) patients with 1-3 times needle aspiration, surgical exploration 33(26.8%) patients with laparoscopic de-roofing 18(14..6%) patients. 1 patient was died due septic shock after operation and some due to massive bleeding during operative procedure. Conclusion: Liver abscess requires a high degree of suspicion for early diagnosis. When appropriate therapy in the form of antimicrobial therapy and radiological intervention in combination with percutaneous drainage or Surgical intervention should be considered for patients with large, complex, or multiple abscesses, underlying disease or in whom percutaneous drainage has failed and it is administered the mortality is very low. However, significant morbidity is still a problem in old debilitated persons with other core morbidities.