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Liver abscess in children: an overview.

Kirtisudha Mishra1, Srikanta Basu, Subhasis Roychoudhury

  • 1Department of Paediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi 110001, India.

World Journal of Pediatrics : WJP
|August 14, 2010
PubMed
Summary

Pediatric liver abscess (LA) remains a concern in developing nations. Treatment trends show a shift towards less invasive methods like percutaneous drainage and antibiotics, significantly reducing mortality rates.

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Area of Science:

  • Pediatric Infectious Diseases
  • Hepatology
  • Surgical Management

Background:

  • Liver abscess (LA) is uncommon in developed countries but prevalent in developing nations.
  • Trends in pediatric LA require review, considering temporal and geographical variations.

Purpose of the Study:

  • To review temporal and geographical trends in pediatric liver abscess.
  • To analyze predisposing causes, clinical presentations, and treatment modalities.

Main Methods:

  • Systematic literature search of PubMed and Google Scholar (1975-2009).
  • Inclusion of retrospective studies, prospective studies, reviews, and case series.
  • Keywords: "liver abscess", "children", "predisposing causes", "clinical signs and symptoms", "treatment".

Main Results:

  • Pyogenic LA is most common, followed by amebic and fungal LA; Staphylococcus aureus is the leading pathogen.
  • Ultrasonography (US) and computed tomography (CT) are primary diagnostic tools.
  • Treatment trends favor less invasive approaches (percutaneous drainage, antibiotics), though open surgery remains important for select cases. Mortality rates for pyogenic and amebic LA have significantly decreased.

Conclusions:

  • Etiological patterns of pediatric LA are consistent, with Staphylococcus aureus predominant.
  • US/CT scans are standard for diagnosis and follow-up.
  • Antimicrobial therapy combined with drainage (percutaneous or open) is the established treatment for pediatric liver abscess.