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[Pyogenic liver abscess--report of 72 cases]
Y S Chen1, F F Chou, S M Sheen Chen
1Department of General Surgery, Gastroenterology, Radiology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi
|March 20, 1990
Summary
Pyogenic liver abscesses, often linked to biliary stones and diabetes, require imaging for diagnosis. Delays in diagnosis and factors like old age and septicemia contribute to a 29% mortality rate.
Area of Science:
- Hepatology
- Infectious Diseases
- Radiology
Context:
- Pyogenic liver abscess (PLA) is a serious intra-abdominal infection.
- Early diagnosis and appropriate management are crucial for patient outcomes.
Purpose:
- To retrospectively review the clinical characteristics, etiology, diagnosis, complications, and prognosis of pyogenic liver abscesses.
- To identify factors associated with poor prognosis and evaluate treatment outcomes.
Summary:
- This study reviewed 72 patients with PLA, noting typical symptoms alongside atypical presentations. Biliary tract stones were the most common cause, with diabetes mellitus frequently associated. Diagnosis relied on imaging (ultrasound or CT), with an average delay of 9.3 days from symptom onset.
- Elevated alkaline phosphatase and leukocytosis were indicative, but imaging confirmed the abscess. Septicemia was the most frequent complication. Poor prognostic factors included advanced age, septicemia, cancer, peritonitis, and elevated serum bilirubin.
- Overall mortality was 29%, with no significant difference in outcomes between surgical drainage and percutaneous transhepatic aspiration or drainage methods.
Impact:
- Highlights the importance of timely diagnosis and recognition of risk factors for improved PLA management.
- Provides insights into the diverse clinical spectrum and common etiologies of PLA.
- Informs clinical decision-making regarding diagnostic strategies and prognostic assessment in PLA patients.