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[Pyogenic liver abscess: changes in etiology, diagnosis and treatment over 18 years]
J C Corredoira Sánchez1, E Casariego Vales, M D Ibáñez Alonso
1Servicio de Medicina Interna, Complexo Hospitalario Xeral-Calde, Lugo.
Background:
There are no detailed studies in our country on the impact of modern imaging techniques on diagnosis, treatment and prognosis of pyogenic liver abscesses.
Material And Methods:
All patients with the diagnosis of PLA from 1981 to 1998 were included in the study. The study was divided in two periods: 1981 to 1989 and 1990 to 1998.
Results:
Compared with the first time period, the following was observed from 1990 to 1998: the mean age was higher (52 versus 65 years, p = 0.006), infections with identified source increased (33% versus 74%, p = 0.003), diagnosis was earlier (13 versus 3 days, p = 0.0002), modern imaging techniques were used more frequently (17% versus 96%, p = 0.002), the proportion of recovered microorganisms increased (53% versus 88%, p = 0.002), as well as use of percutaneous drainage (0% versus 37%, p = 0.002) and the prognosis was better (mortality rate 40% versus 10%, p = 0.01).
Conclusions:
Relevant changes were observed among patients in our hospital in the nineties regarding epidemiology, management and prognosis of PLAs. Part of these changes are due to a higher use of new imaging techniques.