Left-sided liver abscess in childhood

Area of Science:

• Pediatric Surgery
• Hepatology
• Infectious Diseases

Background:

• Liver abscesses are serious infections requiring prompt diagnosis and management.
• Left-sided liver abscesses are less frequent but associated with more complications than right-sided ones.

Purpose of the Study:

• To compare the clinical features, causative organisms, and management outcomes of left-sided versus right-sided liver abscesses in children.
• To identify risk factors and recommend optimal treatment strategies for pediatric liver abscesses.

Main Methods:

• Retrospective review of 124 pediatric liver abscess cases from 1974-1990.
• Analysis of clinical data, microbial cultures, imaging findings (ultrasound), and treatment outcomes.
• Comparison of left-sided (n=26) and right-sided (n=98) abscesses, excluding cases with multiple lobes involved.

Main Results:

• Left-sided abscesses were less common (26 vs. 98) and more frequently solitary (62% vs. 83%).
• Epigastric mass was more frequent in left-sided lesions; otherwise, clinical features were similar.
• Surgical drainage was required in 87.5% of solitary left-sided abscesses versus 64% of solitary right-sided abscesses.
• Three patients with solitary left-sided abscesses experienced rupture; no mortality was observed.

Conclusions:

• Solitary left-sided liver abscesses in children represent a high-risk group requiring prompt surgical intervention.
• Ultrasound plays a crucial role in diagnosis and follow-up.
• Early abscess drainage is recommended for solitary left-sided liver abscesses to prevent complications.