Closed drainage of liver abscesses: the 'UNICAL' drain as an efficient and cost saving device in a tropical setting

Liver abscesses occur in both the developed and developing countries. Up to the time of this study lever abscesses in our centre were drained with open laparotomy, because of the lack of standard equipment for percutaneous drainage. We present a preliminary report of six cases of liver abscesses drained percutaneously using the 'UNICAL' closed drainage system.

Six patients all males aged 23 54 years were treated for liver abscesses using the 'UNICAL' drain (a locally devised active drain system), under ultrasound guidance. Five of the patients had amoebic abscesses, all located in the right hepatic lobe. The sixth patient had multiple pyogenic abscesses involving both hepatic lobes. The six patients had pre and post-drainage antimicrobial therapy for a total of two weeks.

One patient, who was a diabetic, had a recollection of pus within a week after the initial drainage. He was redrained with the same device with complete cure. Full blood count and liver function tests showed anaemia (haemoglobin < 10 g/dl), leucocytosis and hyperbilirubinaemia in five patients.

We conclude that the 'UNICAL' drain is an effective and cheap device for percutaneous drainage of liver abscess under ultrasound guidance in a'resource poor environment'.