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Management of Liver Abscess in Children: Our Experience
Mukta Waghmare1, Hemanshi Shah1, Charu Tiwari1
1Department of Pediatric Surgery, Topiwala National Medical College & B.Y.L. Nair Charitable Hospital, Mumbai, Maharashtra, India.
Insights
Pediatric liver abscesses in India are often treated with antimicrobial therapy and percutaneous drainage. Open surgery is reserved for complex cases, with ultrasound-guided drainage being a common and effective method.
Area of Science:
- Pediatric Hepatology
- Infectious Diseases
- Interventional Radiology
Background:
- Liver abscess is a prevalent condition in the pediatric population in India.
- Children present with distinct predisposing factors and clinical manifestations.
- Liver abscesses are infectious, space-occupying lesions, commonly pyogenic or amebic.
Purpose of the Study:
- To assess the management of liver abscesses in children under 12 years.
- To evaluate treatment modalities based on patient age, etiology, bacteriology, and diagnosis.
Main Methods:
- Retrospective study of 34 pediatric patients (under 12 years) from January 2012 to 2016.
- Assessment of age, etiology, bacteriology, diagnosis, and treatment.
- Analysis of percutaneous needle aspiration and catheter drainage under ultrasound guidance.
Main Results:
- Mean age of presentation was 6.3 years; average abscess volume was 164 cc.
- Ultrasound-guided percutaneous needle aspiration was used in 26.4% of patients.
- Catheter drainage was employed for abscesses >80 cc, with 58.8% undergoing ultrasound-guided percutaneous catheter drainage.
Conclusions:
- Antimicrobial therapy combined with percutaneous drainage is the primary treatment for pediatric liver abscess.
- Open surgical drainage is indicated only for selected, complex cases.
- Percutaneous drainage, particularly ultrasound-guided catheter drainage, is effective for managing pediatric liver abscesses.
Introduction:
Liver abscess is common in pediatric population in India. Children have unique set of predisposing factors and clinical features. Liver abscesses are infectious, space-occupying lesions in the liver; the two most common abscesses being pyogenic and amebic. Its severity depends on the source of the infection and the underlying condition of the patient.
Materials And Methods:
A total of 34 patients less than 12 years were assessed in a retrospective study from January 2012 to 2016. Patients were assessed in terms of age of presentation, etiology, bacteriology, diagnosis, and modality of treatment.
Results:
The mean age of presentation was 6.3 years. Average volume of abscess was 164 cc. Nine patients (26.4%) underwent percutaneous needle aspiration under ultrasound guidance with wide bore needle (18 G disposable needle). Three patients required more than two sittings of aspiration. Patients with volume more than 80 cc were treated with catheter drainage. Twenty patients (58.8%) underwent ultrasound-guided percutaneous catheter drainage. Two patients required catheter drainage for large abscess and needle aspiration for the smaller abscess.
Conclusion:
Antimicrobial therapy along with percutaneous drainage constitutes the mainstay of treatment, whereas open surgical drainage should be reserved for selected cases.How to cite this article: Waghmare M, Shah H, Tiwari C, Khedkar K, Gandhi S. Management of Liver Abscess in Children: Our Experience. Euroasian J Hepato-Gastroenterol 2017;7(1):23-26.
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