Abstract

Background: Liver abscesses, both amoebic and pyogenic, continue to be an important cause of morbidity and mortality in tropical countries. In recent years, imaging guided percutaneous drainage has been increasingly used to treat liver abscess of large size with viscous pus with reported success rates. Our study consists of clinical study (prospective study) of 40 cases of radiologically proven liver abscess and their management by different modalities and their outcome.
Materials& Methods: This is a hospital based prospective study done on 40 cases of radiological proven liver abscess in department of surgery at Government Medical College, Barmer, Rajasthan, India during one year period. USG abdomen was done, using longitudinal, oblique, transverse planes to visualize almost all part of liver. Intercostal and sub costal planes were used. All the liver lesions suggestive of liver abscess were examined in detail (any other abdominal organs were also scanned for any abnormalities). All the patients were hydrated and started on parenteral, third generation cephalosporins and Metronidazole therapy. All patients were simultaneously subjected to USG guided Needle aspiration.
Results: Our study showed that highest incidence (87.5%) of age is found between 3^rd- 6^th decades. Male predominance is always reported in literatures. Liver abscess is commonly seen in low socio-economic group. Ultrasound guided percutaneous needle aspiration was the initial mode of treatment done in our study. Out of 40 patients, 16 patients were successfully treated with single aspiration, 13 required second aspiration, 8 patients were treated with percutaneous catheter drainage after failure of needle aspiration.
Conclusion: Percutaneous needle aspiration is found to be thefirst line of treatment for liver abscess. This method is simple, effective and cheaper. Sinceliver abscess occurs in low strata group in a country like India this procedure is affordable.Percutaneous catheter drainage should be reserved as 2nd line of treatment for large abscesses andabscesses with thick viscous content and for failure of percutaneous needle aspiration cases.