Abstract

Liver abscess is an encapsulated collection of suppurative material within the liver parenchyma, which may be infected by bacterial, fungal and parasitic micro-organisms. The present study was conducted to assess etiology of liver abscess and evaluation of different modalities of its management. Materials & Methods: 50 patients with liver abscess (25 consecutive patients with any of liver abscess was study sample and 25 patients admitted in surgery ward with clinical laboratory and radiological features of liver abscess were divided into two treatment groups: GROUP 1 - Group I with abscess cavity <4 cm – they had received only medical management. GROUP 2 - Group II with abscess cavity >4 cm or smaller abscess which failed to respond to drug therapy alone, left lobe abscess, multiple liver abscess, ruptured liver abscess, they in addition were treated with USG guided – percutaneous needle aspiration or catheter drainage or by surgery. Results: Most of cases belong to age group of 30-40 years and second most common group was 41-50 years and mean age of study subject was 38.4 years. Most of the patients had Amoebic liver abscess (84%). Most of the patients in our study belongs to low socioeconomic status (78%), both amoebic liver abscess and pyogenic liver abscess belongs to low socioeconomic status. There was significant difference in ALT (U/L), AST (U/L), alkaline phosphatase (IU/L), chest x-ray, involvement of lobe, single/multiple abscess, staining of aspirate in patients with amoebic liver abscess and pyogenic liver abscess (P< 0.05). Conclusion: More than 84% patient were of amoebic liver abscess and among pyogenic liver abscess most common pathogen was E coli followed by klebsiella. There is increasing association of diabetes with both type of abscess and alcoholism remains important risk factor. Image guided drainage and open surgery was the best modality of treatment for multiple liver abscess and abscess size >4cm in both pyogenic and amoebic liver abscess however in small size abscess medical management is equally good.

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