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Clinicopathological analysis of liver abscess in Japan
Hiroshi Okano1, Katsuya Shiraki, Hidekazu Inoue
1First Department of Internal Medicine, Mie University School of Medicine, Tsu 514-8507, Japan.
Abstract:
Currently, pyogenic liver abscess is not frequent, but it is a severe infectious disease. However a strategy for the effective treatment of liver abscess is not established. We analyzed 75 cases of liver abscess over an eight year period and evaluated their prognosis, any associated underlying disease, or the effect of percutaneous transhepatic abscess drainage (PTAD). For all 75 cases, laboratory data were analyzed and imaging studies were performed. Next, PTAD and antibiotic administration were started on these cases as first choice treatments. These treatments were continued until the laboratory data of the patient were restored to within the normal range. Those cases that were PTAD non-effective or required operation for underlying diseases, underwent operations. Of the total 75 cases, 63 survived after treatment and 12 cases died. Bacteria were detected in 50 cases and Klebsiella pneumoniae was detected in 31 of these 50 cases, but 25 out of 75 cases were negative. The biliary system was the main route of infection. PTAD was effective, especially in cases that were complicated with disseminated intravascular coagulation (DIC) or acute renal failure (ARF). PTAD is an effective treatment for liver abscess, it is especially useful in the restoration of severe general conditions as indicated by this study.
Insights
Pyogenic liver abscess is a severe infection. Percutaneous transhepatic abscess drainage (PTAD) combined with antibiotics is an effective first-line treatment, particularly for severe cases.
Area of Science:
- Hepatology
- Infectious Diseases
- Interventional Radiology
Background:
- Pyogenic liver abscess is a serious, though infrequent, infectious disease.
- Established treatment strategies for liver abscess remain limited.
- Effective management is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the prognosis and treatment effectiveness of liver abscess.
- To assess the impact of percutaneous transhepatic abscess drainage (PTAD) on patient outcomes.
- To identify associated underlying diseases and infection routes.
Main Methods:
- Retrospective analysis of 75 liver abscess cases over eight years.
- Evaluation of laboratory data and imaging studies.
- First-line treatment with PTAD and antibiotics, followed by surgery if necessary.
Main Results:
- 63 out of 75 patients survived; 12 died.
- Klebsiella pneumoniae was the most common pathogen (31/50 cases with detected bacteria).
- The biliary system was the primary route of infection.
- PTAD showed particular efficacy in patients with disseminated intravascular coagulation (DIC) or acute renal failure (ARF).
Conclusions:
- PTAD is an effective treatment for pyogenic liver abscess.
- This method is especially beneficial for stabilizing patients with severe systemic conditions.
- Early intervention with PTAD can improve survival rates and patient recovery.