Management of 240 cases of liver abscess

The clinical features and surgical management of 240 cases of liver abscess admitted during a period of five years are presented. Incidence of liver abscess was 0.20 per cent of hospital admissions. A peak age incidence in the 4th decade, male preponderance, pain and fever were the striking features. The majority of the abscesses were localised to a single lobe (90.0%). The abscess was sited in the right lobe in 75.1 per cent, in the left lobe in 18.3 per cent and in both lobes in 6.7 per cent. Elevation and limitation of movement of the right dome of the diaphragm was present in 89.5 per cent of cases. Depending upon therapeutic response, aspiration or/and surgical drainage was undertaken. Aspiration was done in 169 patients and surgical drainage in 63 patients. Management of pyogenic liver abscess included early operative intervention preceded by appropriate antibiotic therapy. Surgical intervention is required less often in amoebic abscess and is recommended only after amoebicidal therapy. Open drainage is recommended for the cases associated with complications, left lobe abscess and big abscess.